Unique aspects of antimicrobial use in older adults

Clin Infect Dis. 2005 Apr 1;40(7):997-1004. doi: 10.1086/428125. Epub 2005 Mar 4.


Elderly persons consume a significant proportion of health care resources. Antimicrobials are just one class among many pharmaceuticals that are prescribed more frequently to elderly patients than to younger patients. There are unique aspects of antimicrobial use in elderly persons that make prescribing complicated and monitoring unpredictable. Physiologic changes associated with aging result in altered pharmacokinetics, and accurate estimates of renal function cannot be made with standard methods. Together, these qualities make antimicrobial dosing difficult. Because of a higher prevalence of other chronic diseases, there is a greater propensity for polypharmacy and a resulting risk of an adverse event or a significant drug interaction. Lastly, irrespective of altered pharmacokinetics, adverse effects of many antimicrobials are more common in elderly persons, which introduces an added dimension to ensuring safety with antimicrobial therapy.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Aged
  • Aging / physiology*
  • Anti-Bacterial Agents / adverse effects*
  • Anti-Bacterial Agents / pharmacokinetics
  • Anti-Bacterial Agents / therapeutic use
  • Drug Interactions
  • Humans
  • Polypharmacy


  • Anti-Bacterial Agents