Antibiotic Stewardship for Seniors

senior woman discussing antibiotics with her physician
The bronchitis Rose had been suffering from just wouldn’t seem to go away. Her doctor gave her an antibiotic, but it gave her diarrhea and made her dizzy and nauseous. Rose wondered if the side effects of the antibiotic she was experiencing had something to do with her age. At 75, she is relatively healthy, but seems to catch colds more often than she used to. Rose’s side effects may have been signs of an allergy to antibiotics or worse, a resistance to them, which can cause a Clostridium difficile infection, known as C. diff.

Properly prescribed, antibiotics are used to treat bacteria that can cause certain extreme infections, including pneumonia or sepsis. Antibiotics should not be used for treating viruses like influenza, colds or ear infections.

The Dangers of Antibiotic Resistance

“Each year in the United States, at least 2 million people become infected with bacteria that are resistant to antibiotics and at least 23,000 people die each year as a direct result of these infections.” (

The World Health Organization states, “Antibiotic resistance is one of the biggest threats to global health, food security, and development today. Antibiotic resistance occurs naturally, but misuse of antibiotics in humans and animals is accelerating the process.”

The Center for Disease Control and Prevention warns that the over use of antibiotics is contributing to the growth of antibiotic resistant bacteria. “30% to 50% of antibiotics prescribed in hospitals are unnecessary or inappropriate.” The over use of antibiotics is thought to be prevalent in the senior living communities as well.

Studies show that antibiotics used in livestock are ingested by humans when consumed or applied to the skin. Resistance to antibiotics may be curtailed by reducing or illuminating use of animal products, where the animals have been raised on antibiotics.

Antibiotics and the Elderly

Seniors in residing in long term care centers have a higher risk to bacteria resistance due to an increased exposure to antimicrobials, a decreased immune system, a decrease in functional hygiene, use of pharmaceuticals, and frequent contact with residents and medical staff. Common infections in nursing home residents are UTI, respiratory infections, skin infections, and pneumonia.

Additionally, the elderly is at an increased risk of adverse antibiotic reactions. Drug to drug interactions can affect the safety of antibiotic. Side effects of antibiotic use, such as dizziness or vertigo, are more problematic, as seniors may have existing balance issues. Taking higher and longer antibiotic dosage increases risk for renal and auditory toxicity, which may appear in seniors who already have some renal and auditory. Delirium, caused by some types of antibiotics and present in a high percentage of seniors, can be challenging to identify, especially in seniors with preexisting dementia. Antibiotics can also cause diarrhea and dehydration, which can be dangerous for seniors.

Tips to Stay Healthy

1) Wash your hands before eating, after using the toilet and after having contact with numerous people. The U. S. Food and Drug Administration recommends the use of regular soap and water to reduce bacteria. They note that antibacterial soaps do not perform better, may be hazardous to your health and might contribute to making bacteria resistant to antibiotics. The FDA ruling does not pertain to alcohol based hand sanitizers.

2) Cover your mouth when coughing, but use a tissue or an elbow instead of your hand.

3) Stay home if you are sick and try to minimize contact with others.

4) Get the flu vaccine.

5) Practice safe sex.

6) Follow food safety protocols, such as the WHO Five Keys to Safer Food and eliminate use of products from animals raised with antibiotics.

Antibiotic Awareness – LTC and Acute interventions

The overuse of antibiotics throughout long-term and acute care settings can be reversed by reducing the over-prescribing of antibiotics, reliance on antimicrobial stewardship interventions and observing more precautionary food safety practices.

According to the CDC, “Antimicrobial stewardship interventions have been proven to improve individual patient outcomes, reduce the overall burden of antibiotic resistance, and save healthcare dollars. If everyone — healthcare providers, hospital administrators, policy makers, and patients — works together to employ effective antibiotic stewardship programs, we can improve patient care, more effectively combat antibiotic resistance and ultimately save lives.”

Antibiotics save lives. If you or your senior are prescribed antibiotics by a physician take them exactly as prescribed and call you doctor before discontinuing. Call your healthcare provider immediately if you notice any side effects. Learn more about good antibiotic stewardship by visiting .

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