Application of antibacterial drugs for upper respiratory infections in geriatrics

Application of antibacterial drugs for upper respiratory infections in geriatrics I. IntroductionUpper respiratory infections are one of the common diseases in the elderly population, whose incidence is higher and may be more complex due to factors such as reduced physical functioning and low immunity. Antibacterial drugs have an important place in the treatment of respiratory infections in geriatrics, but their unsound application can lead to drug-resistant bacteria and increased adverse effects. It is therefore important to explore in depth the rational use of anti-bacterial drugs in respiratory infections in old age.II. Characteristics of respiratory infections in old age(i) Physical characteristics and susceptibility to infectionThe respiratory mucous membrane shrinks in older persons, the fibrous movement is reduced, and the sensitivity of cough reflections is reduced, leading to reduced self-purification of the respiratory tract. In addition, the loss of immune function of older persons, the loss of T lymphocytes, and the reduction of B lymphocytes ‘ ability to produce antibodies have reduced the resistance of organisms to pathogens. These physiological changes increase the vulnerability of older persons to upper respiratory infections due to bacterial, viral and other pathogens.(ii) Clinical performance characteristicsClinical manifestations of respiratory infections in old age may be unusual. In comparison to young people, fever symptoms may not be visible or the temperature may increase at a smaller rate, but they are prone to systemic symptoms such as mental atrophy, abated appetite and cognitive disorders. Local symptoms, such as cough and cough, may be light, but because of the poor capacity of older people to cough, the siplet tends to accumulate, increasing the risk of lung infection. Moreover, elderly patients may suffer from a combination of chronic diseases, such as chronic obstructive pulmonary disease, cardiovascular disease, diabetes, etc., which can further affect the development and treatment of upper respiratory infections.Principles of common pathogens and antibacterial drug choice(i) Common pathogensPathogens with respiratory infections in old age are predominantly viral, such as influenza virus, sub-influenza virus, nose virus, coronary virus, etc. However, bacterial infections are also more common, especially when they are followed by bacterial infections. Common bacteria include soluble streptococcus, pneumococcus, haemophilus influenzae, Cartagena Mola, etc. In addition, among older patients with long-term hospitalization or basic illnesses, there is a risk of contracting e.g., e.g., e.g., e.g., e.g., e.g., e.g., coli, cyanobacteria.(ii) Principles of antibacterial choice1. Selection by pathogen typeIn the case of simple viral infections, antibacterial drugs are generally not required, and treatment is the main focus. When bacterial infections are identified or are highly suspected, antibacterial drugs should be selected on the basis of possible pathogens. For example, for soluble streptococcus, pneumonia streptoccus infections, penicillin-like drugs are often preferred, and for influenza haemophilus influenzae infections, Amosilin/Clavic acid is optional.2. Consideration of the individual circumstances of the patient- Hepatal and kidney function: The liver and kidney function of older persons is usually reduced to varying degrees. In the choice of anti-bacterial drugs, the liver and kidney function of the patient needs to be assessed to avoid the use of drugs that have a high degree of damage to the liver and kidney function. For example, amino-sugar-type drugs should be used with caution among elderly patients with inadequate kidney function, as they have kidney and ear toxicity, which can lead to deterioration of kidney function and hearing impairment.- Basic diseases: If patients combine diabetes and are vulnerable to fungi infection, care should be taken to observe signs of fungi infection in the use of antibacterial drugs. In cases of chronic obstructive pulmonary disease, the long-term use of antibacterial drugs may lead to drug-resistant infections, which should be carefully chosen in accordance with the conditions.- The history of drug allergies: Ask patients in detail about the history of drug allergies and avoid the use of antibacterial drugs that can cause allergy. For example, for persons with penicillin allergies, the use of penicillin and headbactrin-type drugs (with the risk of cross-sensitivity) should be avoided, with the option of replacing drugs such as large cyclopentone or quinone.3. Following recommendations for evidence-based medical evidence and guidanceClinicians should choose antibacterial drugs by reference to the latest clinical guidelines and evidence-based medical research. For example, with regard to community access to sexual respiratory infections, there are treatment guidelines that recommend the choice of first- and second-line antibacterial drugs, and doctors should use them rationally in the light of the guidelines.Application of commonly used antibacterial drugs in respiratory infections in geriatrics(i) Penicillin1. Mechanisms of action and antibacterial spectrometryPenicillin-type drugs are microbicides by inhibiting the synthesis of bacterial cell walls. Better antibacterial activity, mainly for gland positive bacteria such as soluble streptococcus and pneumococcus. It is highly virulent and of low toxicity, but it is vulnerable to the hydrolysis of beta-implamide from bacteria.2. Application characteristics among older patientsFor older patients without an allergy of penicillin, penicillin G can be used to treat upper respiratory infections such as soluble streptococcus, and tonsils. However, because of the possible reduction of kidney function in older persons, care needs to be taken to adjust the dose in large doses of penicillin-type drugs, while changes in kidney function and electrolyte are closely monitored. Moreover, care is taken against the production of drug-resistant strains for elderly patients who have repeatedly used penicillin-type drugs.(ii) CapricornsClassification and antibacterial spectrometryDrugs such as head sepsis are divided into four generations based on their antibacterial spectrometry and stability to the beta-implamide. The first generation of enzymes, which have a strong antibacterial effect mainly on gland positive bacteria, can be used for infections such as penicillin-sensitive pneumocococcus, soluble streptococcus, etc. in the upper respiratory tract of old age. The antibacterial activity of second-generation sepsis is similar to or slightly worse than that of the first generation, but the antibacterial activity of the gerang fungi is enhanced and can be used to treat upper respiratory infections such as haemophilus influenzae. Third-generation enzymes are more antibacteria-resistant to the grenacella and more stable to the β-neamide enzyme, which is applicable to older patients at risk of or mixed with the grenacella. The fourth generation has a broader antibacterial spectrum, with good antibacterial activity for the Grelan positives and the Grelan cactus and a high degree of stability for the β-neamase.2. Negative effects and concernsThe most common adverse effects of a drug such as a sepsis include allergies, gastrointestinal reactions, etc. When used by older patients, care is taken to ask about allergies. Since some older patients may use other drugs at the same time, attention should be paid to the interaction between drugs. For example, the combination of amino-sugar-type drugs may increase renal toxicity and the combination of anticondensatives may increase the risk of haemorrhage. Also, a drug such as a hemorrhoids may affect the intestinal cobalt balance, leading to double-infection, which needs to be closely observed among older patients in long-term use.(iii) Large ringed esters1. Antibacterial mechanisms and characteristicsLarge ethyl esters are anti-bacterial by inhibiting the synthesis of bacterial proteins by combining with bacterial nucleus 50S. Antibacterial activity has been observed for gland positive bacteria such as pneumocococcus and soluble streptococcus, as well as better antibacterial effects on atypical pathogens, such as chlamydia and chlamydia. The high concentrations of such drugs in respiratory tissues facilitate the treatment of upper respiratory infections.2. Strengths and shortcomings among older patientsIn the case of respiratory infections in geriatrics, large cycloesters are commonly used in cases of penicillin allergic or suspected atypical pathogen infections. The advantage is that the gastrointestinal response is relatively light and the interaction with other drugs is relatively low. However, hepatic function may be impaired by GHP-type drugs, which need to be monitored on a regular basis when used by older patients, especially those with an abnormal basis for liver function. Moreover, the long-term use of large cyclopentone-type drugs may induce bacterial resistance and should avoid abuse.(iv) XenoneClassification and resistanceQuinone-type drugs are divided into four generations, with third and fourth generations currently commonly used in clinical practice. The third generation of drugs such as quinone, such as left-oxen fluoride, Mossa, have a strong anti-bacterial activity for the geran vaginal bacteria, as well as some anti-bacterial effects for the geran positives, such as pneumocococcus, and are also effective for atypical pathogens, such as chlamydia and chlamydia. The fourth generation of quinone-type drugs has a broader antibacterial spectrum and greater antibacterial activity.2. Safety and care among older patientsThe use of quinone-type drugs among older patients requires caution. Such drugs may affect the growth of the cartilage, although there are no growth problems among older patients, but they may be associated with joint diseases of older persons, such as increasing the risk of myrmitis and fibrosis. At the same time, quinone-type drugs can cause adverse reactions to the central nervous system, such as dizziness, insomnia, mental abnormalities, etc. and are more likely to occur among older patients. In addition, as quinone-type drugs can affect blood sugar metabolism, changes in blood sugar are closely monitored during the use of the group of older patients with diabetes.V. Joint application of antibacterial drugs(i) Indicators of joint applicationIn the case of respiratory infections in geriatrics, the main indications for the combined application of antibacterial drugs are: 1. A combination of infections that cannot be controlled by a single antibacterial drug, such as the co-infection of gland positives and gland vaginal infections. 2. The joint use of antibacterial drugs for the purpose of covering possible pathogens, pending the acquisition of a pathogen diagnosis, due to undetected serious infections. 3. The long-term use of antibacterial drugs may lead to the creation of resistant bacteria, and joint use of drugs can reduce the occurrence of resistant drugs, such as antibacterial drugs that can be used in combination with different mechanisms for the treatment of acute increases in chronic obstructive pulmonary disease.(ii) Programmes for joint applicationsCommon joint application programmes include a combination of beta- and beta- and intramamase inhibitors, such as amoxicillin/clavic acid, which enhances antibacterial activity against enzyme-producing bacteria. Convergence with the large cycloethrin can cover more pathogens and apply to the community ‘ s access to upper respiratory infections such as pneumonia. However, joint drug use should take into account the increased interaction and adverse effects of the drug, such as the risk of increased gastrointestinal reaction, liver and kidney damage during joint use, and the need for close observation of changes in the patient ‘ s condition and adverse effects.VI. The treatment of antibacterial drugs and evaluation of their efficacy(i) TreatmentIn the case of older persons with respiratory infections, the course of treatment of antibacterial drugs depends on the type of pathogen, the severity of the condition and the individual condition of the patient. In general, for upper respiratory infections caused by simple bacterial infections, such as acute tonsilitis, oscillitis, etc., the course of treatment is usually 7-10 days. In the case of a combination of patients with a basic disease or a more serious condition, the treatment may require an appropriate extension. In the case of subsequent bacterial infections of the virus, antibacterial drugs should continue to be used for 3 to 5 days, after normal body temperature and abating symptoms. However, it is important to avoid excessive use of antibacterial drugs leading to increased drug resistance and adverse reactions.(ii) Assessment of efficacyThe assessment of the efficacy of the treatment consists mainly of improvements in clinical symptoms and signs, laboratory results, etc. Clinical symptoms such as fever, cough, cough, etc. have decreased or disappeared, mental state has improved and appetite has increased as a sign of better health. In terms of signs, the reduction or disappearance of the lung hearing also suggests that treatment is effective. In laboratory tests, normal rates of regular blood white cell count and moderate particle cell ratio have been restored, and the decline in in inflammation indicators, such as C-reacting protein, calcium reduction, can also be used as a basis for evaluating the efficacy of treatment. If there is no significant improvement or deterioration in the treatment, the pathogen should be re-evaluated in a timely manner and antibacterial treatment programmes adjusted.ConclusionAntibacterial drugs play a key role in the treatment of respiratory infections in the gerontology, but there is a need for rational choice of antibacterial drugs, taking full account of the physiological characteristics of older persons, the type of pathogen, underlying diseases, etc. Strict adherence to the principle of choice of antibacterial drugs, attention to adverse reactions and interactions, regulation of the joint application of antibacterial drugs, accurate assessment of the therapeutic process and efficacy of treatment in order to improve treatment effectiveness, reduce the occurrence of resistant bacteria and adverse reactions, and guarantee the safety and quality of treatment for elderly patients. At the same time, increased care and prevention measures for older persons, such as increased immunity and protection from exposure to the sources of infection, are important in reducing the incidence of upper respiratory infections. In clinical practice, continuous learning and application of the latest research findings and guidance recommendations to improve the level of treatment for respiratory infections in geriatrics.