Precautions
for the use of antibiotics in the elderly
With the aggravation of population aging, the health problems of elderly patients have been paid more and more attention. In medical practice, elderly patients need to be more cautious and meticulous in the use of antibiotics because of the decline of physiological function and the weakening of immune function. The following are detailed precautions for the use of antimicrobial drugs in the elderly, aimed at ensuring the safety and effectiveness of medication.
1. Understanding the physical characteristics
of the elderly Physiological dysfunction: Elderly patients generally have physiological degenerative diseases of tissues and organs, such as decreased renal function, decreased liver metabolic detoxification function, etc. These changes can affect the absorption, distribution, metabolism and excretion of drugs, resulting in increased blood concentration and increased risk of adverse reactions.
Decreased immune function: The immune system function of the elderly is gradually weakened, the resistance to infection is reduced, and infectious diseases are prone to occur. At the same time, after infection, the disease may be more serious and the recovery rate is slower.
Complications: Elderly patients often suffer from a variety of chronic diseases, such as hypertension, diabetes, coronary heart disease, etc., which may affect the choice and use of antibiotics.
2. Select appropriate antibacterial drugs
Choose drugs with low toxicity: elderly patients should choose antibacterial drugs with low toxicity and bactericidal effect, such as penicillins (pay attention to skin test), cephalosporins and other β-lactams. Avoid the use of drugs with high nephrotoxicity, such as aminoglycosides and vancomycin, unless there are clear indications for use and under the guidance of doctors.
According to the selection of drug sensitivity test: before antibiotic treatment, the secretion samples of infected sites should be collected as far as possible for bacterial culture and drug sensitivity test to guide precise drug use. This helps to select antimicrobial agents that are sensitive and have few side effects.
Consider drug interactions: Elderly patients often take multiple drugs at the same time, and attention should be paid to the interaction between antibiotics and other drugs to avoid adverse consequences. For example, the use of cephalosporin antibiotics in combination with certain diuretics may result in increased renal impairment, and in combination with warfarin may enhance anticoagulation and cause abnormal bleeding.
3. Adjust the dosage and dosage regimen
of drugs Reduced dosage: In view of renal hypofunction in elderly patients, the dosage of antibiotics mainly excreted by the kidney should be reduced according to mild renal hypofunction, generally 1/2 to 2/3 of the normal therapeutic dose.
Regular monitoring: During the use of antibiotics, liver and kidney function, blood routine and other indicators should be checked regularly to detect and deal with adverse drug reactions in time. Especially when it is used for a long time or in large doses, close attention should be paid.
Individualized administration: according to the specific conditions of patients (such as age, weight, liver and kidney function, etc.), the individualized administration plan is formulated to improve the efficacy and reduce adverse reactions.
4. Pay attention to diet and living habits
Light and digestible diet: During the use of antibiotics, elderly patients should avoid eating spicy, greasy and irritating food, so as not to increase the burden on the gastrointestinal tract. It is suggested to eat more vegetables, fruits, porridge and other light and digestible foods to maintain a balanced nutrition.
Drink water in moderation: Maintaining adequate water intake helps to promote drug excretion and reduce the risk of drug accumulation in the body. However, attention should be paid to avoid water poisoning caused by excessive drinking water.
Avoid alcohol: Alcohol may react with some antibacterial drugs, affecting the efficacy of drugs or increasing the risk of adverse reactions. Therefore, alcohol should be avoided during the use of cephalosporin antibiotics and for a period of time after withdrawal.
Pay attention to rest: ensure adequate sleep and rest to help the body recover and improve immunity. Elderly patients should pay more attention to rest and avoid overwork during the use of antibiotics.
5. Observe and deal with adverse reactions
Anaphylaxis: Cephalosporin antibiotics may cause allergic reactions, including rash, itching, expiratory dyspnoea and other symptoms. Once an allergic reaction occurs, the drug should be stopped immediately and treated by medical treatment.
Digestive tract symptoms: Some patients may have nausea, vomiting, diarrhea and other digestive tract symptoms. Mild symptoms can be alleviated by adjusting diet, while severe symptoms require timely medical treatment.
Nervous system symptoms: a small number of patients may have dizziness, headache, insomnia and other nervous system symptoms. If the symptoms continue to worsen or affect the quality of daily life, they should seek medical advice in time.
Liver and kidney damage: Long-term or high-dose use of cephalosporin antibiotics may cause damage to liver and kidney function. Relevant indicators should be closely monitored in the process of use, and abnormal situations should be found and dealt with in time.
In short, the elderly need to be particularly cautious when using antibiotics. By understanding their own physical condition, choosing appropriate drugs, adjusting dosage and dosage regimen, paying attention to diet and living habits, and timely observation and treatment of adverse reactions, we can maximize the therapeutic effect and reduce the occurrence of adverse reactions. At the same time, they should also use drugs rationally under the guidance of doctors, and do not increase or decrease the dosage or change the drug varieties by themselves.
