Prescription of antimicrobial agents to elderly people in relation to the type of infection

Abstract

Objective: to describe how frequently antimicrobial agents are prescribed for elderly people and to examine the prescribing practice of treating physicians. Design: for each of the 1196 subjects examined, a review of the medical records was carried out for the year preceding the examination and data on antimicrobial prescriptions, including types of infections, were recorded. The sales statistics of antimicrobial agents in this population were compared with tile nation-wide ones, collected by the National Agency for Medicines. Setting: a health centre in Lieto, a rural district in southwestern Finland; 1990-91. Subjects: 1196 subjects, aged 64-97 years, 488 men and 708 women. Main outcome measures: frequencies of prescriptions of specified antimicrobial agents, including types of infection in relation to gender and form of care over a 1-year period. Results: more women (36%) than men (28%) had received antimicrobial agents. The proportion who had received such agents increased with increasing age, the trend being more marked in men. The mean number of prescriptions per user per year was slightly lower in men than women (0.6 and 0.7 respectively). In both sexes, 54% of the users of antimicrobial agents had received only one prescription. Cephalosporins and penicillins were the most commonly prescribed agents. Among those who had received three or more antimicrobial prescriptions, cephalosporins had been used most frequently. Elderly people living in long-term institutional care were treated with antimicrobial agents more frequently than those living outside institutions. Of all antimicrobial prescriptions given to women, 60% were prescribed for urinary tract infections, 21% for respiratory infections and 8% for skin infections. The figures for men were 18, 45 and 10%. Conclusions: multiple use of antimicrobial agents is common in old age, especially in those in institutions. More attention should be to the provision of appropriate antimicrobial treatment.