Monday , July 29 , 2019
Is antibiotic use in older adults always the best choice?
When an older adult becomes ill, even a simple infection can quickly turn into something much larger. UTIs, in particular, are notorious for leading to sepsis when left untreated. But is immediately throwing a senior citizen on an antibiotic always the best option?
Not exactly.
When a younger adult goes to the doctor with an infection, treatment with antibiotics is a no-brainer. In fact, it’s standard protocol. But in the elderly, “standard protocol” can have some very serious repercussions.
New research lends credence to the fact that healthcare professionals should be treating individuals, not symptoms. Even when lab results come back with an astounding “positive”, factors like age and functionality need to be taken into consideration before prescribing a drug.
Antibiotics and urinary tract infections
An antibiotic (such as penicillin) is a medicine that inhibits the growth of or destroys bacteria. They are used in people of all ages to treat everything from minor illnesses to life-threatening infections, with much success.
Often, drugs such as Cipro or Bactrim are prescribed to help fight urinary tract infections. For most people, these are highly effective treatments. For older adults, however, they may do more harm than good.
Why? Because even though a senior citizen has bacteria in their urine, it DOES NOT mean they actually have a UTI.
It is not uncommon for trace bacteria to show up on a urinalysis, but unless symptoms (such as painful urination or increased frequency) are present, a UTI is unlikely.
What happens when antibiotics are unnecessarily prescribed?
When an antibiotic is prescribed despite the lack of infection, it doesn’t do much good at all. In fact, it may do some pretty serious damage.
For younger people, treatment with an antibiotic usually puts them ‘back where they were before’: Healthy and able, like nothing ever happened. But for older adults, it doesn’t necessarily work that way.
Instead, treatment with antibiotics (necessary or not) can lead to increased confusion, worsening dementia, a weaker immune system, nerve damage, and a whole slew of physical ailments such as diarrhea and vomiting.
Even more alarming: Excessive use of antibiotics can help drug resistant bacteria to grow. These bacteria are more difficult to kill, as they’ve developed immunity to most of the more commonly prescribed drugs. According to the Centers for Disease Control and Prevention, every year, more than 2 million people in the United States acquire antibiotic-resistant infections, with at least 23,000 people dying as a result.
When are antibiotics appropriate?
If an older adult tests positive for bacteria in the urine AND has symptoms of a UTI, antibiotics may help.
Classic UTI symptoms include burning, pelvic pain, frequent urination, an increased urgency to urinate, fever, and urine with an abnormal odor. For the elderly, however, symptoms may not be so obvious. Some of the less-typical symptoms which present in older adults include:
- Incontinence
- Agitation
- Confusion
- Lethargy
- Decreased mobility and appetite
Final thoughts
Deciding whether or not to use antibiotics can be a scary prospect. On the one hand, you want to trust what the doctor says and, of course, avert more serious infection. On the other hand, you want to avoid any unnecessary complications and ailments down the road. Ultimately, you just have to make the best decision possible given the information you have (but it never hurts to get a second opinion!)
Posted in: Health
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