The critically ill older patient with sepsis: a narrative review

Annals of Intensive Care, Journal Year: 2024, Volume and Issue: 14(1)

Published: Jan. 10, 2024

Abstract Sepsis is a significant public health concern, particularly affecting individuals above 70 years in developed countries. This crucial fact due to the increasing aging population, their heightened vulnerability sepsis, and associated high mortality rates. However, morbidity long-term outcomes are even more notable. While many patients respond well timely appropriate interventions, it imperative enhance efforts identifying, documenting, preventing, treating sepsis. Managing sepsis older poses greater challenges necessitates comprehensive understanding of predisposing factors suspicion for diagnosing infections assessing risk sudden deterioration into Despite age often being considered an independent factor morbidity, recent research emphasizes pivotal roles frailty, disease severity, comorbid conditions influencing outcomes. In addition, important inquire about patient's preferences establish personalized treatment plan that considers potential recovery with quality life functional review provides summary most aspects consider when dealing old critically ill patient

Language: Английский

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Antibiotic Resistance in the Elderly: Mechanisms, Risk Factors, and Solutions

Microorganisms, Journal Year: 2024, Volume and Issue: 12(10), P. 1978 - 1978

Published: Sept. 30, 2024

Antibiotic resistance presents a critical challenge in healthcare, particularly among the elderly, where multidrug-resistant organisms (MDROs) contribute to increased morbidity, mortality, and healthcare costs. This review focuses on mechanisms underlying key bacterial pathogens highlights how aging-related factors like immunosenescence, frailty, multimorbidity increase burden of infections from MDROs this population. Novel strategies mitigate include development next-generation antibiotics teixobactin cefiderocol, innovative therapies such as bacteriophage therapy antivirulence treatments, implementation antimicrobial stewardship programs optimize antibiotic use. Furthermore, advanced molecular diagnostic techniques, including nucleic acid amplification tests sequencing, allow for faster more precise identification resistant pathogens. Vaccine development, through approaches multi-epitope vaccines nanoparticle-based platforms, holds promise preventing MDRO elderly. The role machine learning (ML) predicting patterns aiding vaccine is also explored, offering promising solutions personalized treatment prevention By integrating cutting-edge diagnostics, therapeutic innovations, ML-based approaches, underscores importance multidisciplinary efforts address global aging populations.

Language: Английский

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Age-stratified analysis of adverse event signals for clarithromycin: a disproportionality analysis using the FDA Adverse Event Reporting System

Therapeutic Advances in Drug Safety, Journal Year: 2025, Volume and Issue: 16

Published: Jan. 1, 2025

Background: Clarithromycin is a widely used antibiotic, but its safety profile, particularly in different age groups, remains inadequately explored. Objectives: This study aims to characterize and illustrate the features of clarithromycin-related adverse events (AEs) across groups using FDA Adverse Event Reporting System (FAERS) database, providing reference for clinical detection, prevention, management AEs various groups. Design: A disproportionality analysis was performed data from FAERS database. The included all AE reports related clarithromycin, stratified by Methods: Disproportionality conducted reporting odds ratio, proportional Bayesian confidence propagation neural network, multiple gamma Poisson shrinkers. Statistical analyses descriptive statistics Chi-square tests. Results: total 7319 clarithromycin were retrieved Vomiting, diarrhea, drug interactions, interactions reported most frequently 0–17, 18–44, 45–64, ⩾65 years, respectively. Abnormal product taste, taste disorder, medication errors specified package insert strongest signals 41 Preferred Terms not explicitly mainly associated with psychiatric disorders, skin subcutaneous tissue gastrointestinal among others. Specific differences identified, 18 being age-specific, including 3 children 15 elderly individuals. Conclusion: profile varies In children, it vomiting, hypersensitivity, dyspnea, while adults, are more common. elderly, should be cautiously, attention interactions.

Language: Английский

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A Comprehensive 10-Year Nationwide Pharmacovigilance Surveillance on Antibacterial Agents in Korea: Data Mining for Signal Detection of Trends and Seriousness of Adverse Events

Microorganisms, Journal Year: 2025, Volume and Issue: 13(1), P. 136 - 136

Published: Jan. 10, 2025

A comprehensive pharmacovigilance surveillance on antibacterials is lacking. This study aims to investigate safety signals of antibacterial-related adverse drug events (ADEs) with seriousness and identify predictors serious ADEs. investigated 52,503 antibacterial-induced ADEs reported the Korea Adverse Event Reporting System Database from January 2013 December 2022. Disproportionality analysis was conducted, effect sizes were estimated by reporting odds ratios (ROR), proportional ratio (PRR), information component (IC). Multivariate logistic regression performed estimating (OR). Serious more likely be cardiovascular disorders (ROR 6.77, PRR 6.6, IC 2.37), urinary system 5.56, 5.22, 2.12), platelet, bleeding, clotting 5.41, 5.17, 2.06). The may include age (OR 1.05), number concomitant medications 1.44), proton pump inhibitors 1.46) non-steroidal anti-inflammatory drugs 1.38) use, specific antibacterial classes, while multiple therapy associated lower ADE risks. sensitivity also suggests male sex 1.18) as a potential predictor However, further studies are imperative determine causality in critically ill patients.

Language: Английский

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Helicobacter pylori Eradication Treatment in Older Patients

Drugs & Aging, Journal Year: 2024, Volume and Issue: 41(2), P. 141 - 151

Published: Feb. 1, 2024

Language: Английский

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Feeding Drosophila gut microbiomes from young and old flies modifies the microbiome

Scientific Reports, Journal Year: 2024, Volume and Issue: 14(1)

Published: April 2, 2024

Abstract It is becoming increasingly evident that the myriad of microbes in gut, within cells and attached to body parts (or roots plants), play crucial roles for host. Although this has been known decades, recent developments molecular biology allow expanded insight into abundance function these microbes. Here we used vinegar fly, Drosophila melanogaster , investigate fitness measures across lifetime flies fed a suspension gut harvested from young or old flies, respectively. Our hypothesis was constitutively enriched with ‘Young microbiome’ would live longer be more agile at age (i.e. have increased healthspan) compared an ‘Old microbiome’. Three major take home messages came out our study: (1) microbiomes differ markedly; (2) feeding Young Old altered microbiome recipient (3) two different microbial diets did not any effect on locomotor activity nor lifespan contradicting working hypothesis. Combined, results provide novel interplay between hosts their clearly highlight phenotypic effects transplants probiotics can complex unpredictable.

Language: Английский

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Biomarkers of chronic kidney disease in older individuals: navigating complexity in diagnosis

Frontiers in Medicine, Journal Year: 2024, Volume and Issue: 11

Published: July 11, 2024

Chronic kidney disease (CKD) in older individuals is a matter of growing concern the field public health across globe. Indeed, prevalence function impairment increases with advancing age and often exacerbated by age-induced modifications function, presence chronic diseases such as diabetes, hypertension, cardiovascular disorders, increased burden related to frailty, cognitive sarcopenia. Accurate assessment CKD crucial for timely intervention management relies heavily on biomarkers diagnosis monitoring. However, interpretation these patients may be complex due interplays between CKD, aging, geriatric syndromes. Biomarkers serum creatinine, estimated glomerular filtration rate (eGFR), albuminuria can significantly altered systemic inflammation, metabolic changes, medication use commonly seen this population. To overcome limitations traditional biomarkers, several innovative proteins have been investigated potential, review we aimed at consolidating existing data concerning aspects describing challenges considerations using assess patients, highlighting need integration clinical context improve biomarkers’ accuracy.

Language: Английский

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Influence of Ageing on the Pharmacodynamics and Pharmacokinetics of Chronically Administered Medicines in Geriatric Patients: A Review

Clinical Pharmacokinetics, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 11, 2025

As people age, the efficiency of various regulatory processes that ensure proper communication between cells and organs tends to decline. This deterioration can lead difficulties in maintaining homeostasis during physiological stress. includes but is not limited cognitive impairments, functional difficulties, issues related caregivers which contribute significantly medication errors non-adherence. These factors higher morbidity, extended hospital stays, reduced quality life, even mortality. The decrease homeostatic capacity varies among individuals, contributing greater variability observed geriatric populations. Significant pharmacokinetic pharmacodynamic alterations accompany ageing. Pharmacokinetic changes include decreased renal hepatic clearance an increased volume distribution for lipid-soluble drugs, prolong their elimination half-life. Pharmacodynamic typically involve sensitivity drug classes, such as anticoagulants, antidiabetic psychotropic medications. review examines primary age-related geriatrics impact on pharmacokinetics pharmacodynamics

Language: Английский

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Optimizing epidemic prevention in nursing homes using clinical surveillance of respiratory infections

Infection Prevention in Practice, Journal Year: 2025, Volume and Issue: unknown, P. 100444 - 100444

Published: Jan. 1, 2025

Language: Английский

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Managing Helicobacter pylori as an Infectious Disease: Implementation of Antimicrobial Stewardship

Helicobacter, Journal Year: 2025, Volume and Issue: 30(1)

Published: Jan. 1, 2025

ABSTRACT Helicobacter pylori is prevalent globally and implicated in various gastric diseases malignancies. Rising antibiotic resistance has increasingly compromised the effectiveness of standard H. eradication therapies. This review explores role antimicrobial stewardship (AMS) as a structured approach to optimizing management through “5D” strategy: Diagnosis—utilizing advanced diagnostic tools accurately detect bacterial resistance; Drug—selecting antibiotics tailored profiles patient‐specific factors; Dosage—optimizing dosing frequency based on pharmacokinetic properties maximize efficacy; Duration—employing shorter treatment courses where supported by evidence; Discontinuation—balancing benefits risks repeated treatments. We discuss recent advances technologies, such polymerase chain reaction next‐generation sequencing, their impact therapeutic decision‐making. Additionally, we evaluate regimens, with particular focus emerging alternatives regimens containing potassium‐competitive acid blockers. Given growing global limited pipeline for new antibiotics, advocate more strategic resource‐conscious management, integrating AMS principles within “One Health” framework address pathogen's transmission across humans, animals, environment. With advancements testing diagnostics, therapies are likely become personalized precise. To achieve this, effective implementation necessitates interdisciplinary collaboration outcomes, minimize adverse effects, combat resistance, reduce healthcare costs.

Language: Английский

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