Pharmacotherapy of Lower Respiratory Tract Infections in Elderly—Focused on Antibiotics
Identifieur interne : 000C16 ( Ncbi/Merge ); précédent : 000C15; suivant : 000C17Pharmacotherapy of Lower Respiratory Tract Infections in Elderly—Focused on Antibiotics
Auteurs : Yang Liu [République populaire de Chine] ; Yan Zhang [République populaire de Chine] ; Wanyu Zhao [République populaire de Chine] ; Xiaolei Liu [République populaire de Chine] ; Fengjuan Hu [République populaire de Chine] ; Birong Dong [République populaire de Chine]Source :
- Frontiers in Pharmacology [ 1663-9812 ] ; 2019.
Abstract
Lower respiratory tract infections (LRTIs) refer to the inflammation of the trachea, bronchi, bronchioles, and lung tissue. Old people have an increased risk of developing LRTIs compared to young adults. The prevalence of LRTIs in the elderly population is not only related to underlying diseases and aging itself, but also to a variety of clinical issues, such as history of hospitalization, previous antibacterial therapy, mechanical ventilation, antibiotic resistance. These factors mentioned above have led to an increase in the prevalence and mortality of LRTIs in the elderly, and new medical strategies targeting LRTIs in this population are urgently needed. After a systematic review of the current randomized controlled trials and related studies, we recommend novel pharmacotherapies that demonstrate advantages for the management of LRTIs in people over the age of 65. We also briefly reviewed current medications for respiratory communicable diseases in the elderly. Various sources of information were used to ensure all relevant studies were included. We searched Pubmed, MEDLINE (OvidSP), EMBASE (OvidSP), and ClinicalTrials.gov. Strengths and limitations of these drugs were evaluated based on whether they have novelty of mechanism, favorable pharmacokinetic/pharmacodynamic profiles, avoidance of interactions and intolerance, simplicity of dosing, and their ability to cope with challenges which was mainly evaluated by the primary and secondary endpoints. The purpose of this review is to recommend the most promising antibiotics for treatment of LRTIs in the elderly (both in hospital and in the outpatient setting) based on the existing results of clinical studies with the novel antibiotics, and to briefly review current medications for respiratory communicable diseases in the elderly, aiming to a better management of LRTIs in clinical practice.
Url:
DOI: 10.3389/fphar.2019.01237
PubMed: 31736751
PubMed Central: 6836807
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<front><div type="abstract" xml:lang="en"><p>Lower respiratory tract infections (LRTIs) refer to the inflammation of the trachea, bronchi, bronchioles, and lung tissue. Old people have an increased risk of developing LRTIs compared to young adults. The prevalence of LRTIs in the elderly population is not only related to underlying diseases and aging itself, but also to a variety of clinical issues, such as history of hospitalization, previous antibacterial therapy, mechanical ventilation, antibiotic resistance. These factors mentioned above have led to an increase in the prevalence and mortality of LRTIs in the elderly, and new medical strategies targeting LRTIs in this population are urgently needed. After a systematic review of the current randomized controlled trials and related studies, we recommend novel pharmacotherapies that demonstrate advantages for the management of LRTIs in people over the age of 65. We also briefly reviewed current medications for respiratory communicable diseases in the elderly. Various sources of information were used to ensure all relevant studies were included. We searched Pubmed, MEDLINE (OvidSP), EMBASE (OvidSP), and ClinicalTrials.gov. Strengths and limitations of these drugs were evaluated based on whether they have novelty of mechanism, favorable pharmacokinetic/pharmacodynamic profiles, avoidance of interactions and intolerance, simplicity of dosing, and their ability to cope with challenges which was mainly evaluated by the primary and secondary endpoints. The purpose of this review is to recommend the most promising antibiotics for treatment of LRTIs in the elderly (both in hospital and in the outpatient setting) based on the existing results of clinical studies with the novel antibiotics, and to briefly review current medications for respiratory communicable diseases in the elderly, aiming to a better management of LRTIs in clinical practice.</p>
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<pmc article-type="review-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Front Pharmacol</journal-id>
<journal-id journal-id-type="iso-abbrev">Front Pharmacol</journal-id>
<journal-id journal-id-type="publisher-id">Front. Pharmacol.</journal-id>
<journal-title-group><journal-title>Frontiers in Pharmacology</journal-title>
</journal-title-group>
<issn pub-type="epub">1663-9812</issn>
<publisher><publisher-name>Frontiers Media S.A.</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">31736751</article-id>
<article-id pub-id-type="pmc">6836807</article-id>
<article-id pub-id-type="doi">10.3389/fphar.2019.01237</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Pharmacology</subject>
<subj-group><subject>Review</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group><article-title>Pharmacotherapy of Lower Respiratory Tract Infections in Elderly—Focused on Antibiotics</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Liu</surname>
<given-names>Yang</given-names>
</name>
<xref ref-type="aff" rid="aff1"><sup>1</sup>
</xref>
<xref ref-type="aff" rid="aff2"><sup>2</sup>
</xref>
<uri xlink:type="simple" xlink:href="https://loop.frontiersin.org/people/762081"></uri>
</contrib>
<contrib contrib-type="author"><name><surname>Zhang</surname>
<given-names>Yan</given-names>
</name>
<xref ref-type="aff" rid="aff1"><sup>1</sup>
</xref>
<xref ref-type="aff" rid="aff2"><sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Zhao</surname>
<given-names>Wanyu</given-names>
</name>
<xref ref-type="aff" rid="aff1"><sup>1</sup>
</xref>
<xref ref-type="aff" rid="aff2"><sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Liu</surname>
<given-names>Xiaolei</given-names>
</name>
<xref ref-type="aff" rid="aff1"><sup>1</sup>
</xref>
<xref ref-type="aff" rid="aff2"><sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Hu</surname>
<given-names>Fengjuan</given-names>
</name>
<xref ref-type="aff" rid="aff1"><sup>1</sup>
</xref>
<xref ref-type="aff" rid="aff2"><sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Dong</surname>
<given-names>Birong</given-names>
</name>
<xref ref-type="aff" rid="aff1"><sup>1</sup>
</xref>
<xref ref-type="aff" rid="aff2"><sup>2</sup>
</xref>
<xref ref-type="author-notes" rid="fn001"><sup>*</sup>
</xref>
</contrib>
</contrib-group>
<aff id="aff1"><sup>1</sup>
<institution>The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University</institution>
,<addr-line>Chengdu</addr-line>
,<country>China</country>
</aff>
<aff id="aff2"><sup>2</sup>
<institution>Geriatric Health Care and Medical Research Center, Sichuan University</institution>
,<addr-line>Chengdu</addr-line>
,<country>China</country>
</aff>
<author-notes><fn fn-type="edited-by"><p>Edited by: Min Yang, Anhui Medical University, China</p>
</fn>
<fn fn-type="edited-by"><p>Reviewed by: Yaser Mohammed Al-Worafi, Ajman University of Science and Technology, United Arab Emirates; Natasa Duborija-Kovacevic, University of Montenegro, Montenegro</p>
</fn>
<corresp id="fn001">*Correspondence: Birong Dong, <email xlink:href="mailto:birongdong@163.com" xlink:type="simple">birongdong@163.com</email>
</corresp>
<fn fn-type="other" id="fn002"><p>This article was submitted to Pharmaceutical Medicine and Outcomes Research, a section of the journal Frontiers in Pharmacology</p>
</fn>
</author-notes>
<pub-date pub-type="epub"><day>31</day>
<month>10</month>
<year>2019</year>
</pub-date>
<pub-date pub-type="collection"><year>2019</year>
</pub-date>
<volume>10</volume>
<elocation-id>1237</elocation-id>
<history><date date-type="received"><day>28</day>
<month>6</month>
<year>2019</year>
</date>
<date date-type="accepted"><day>27</day>
<month>9</month>
<year>2019</year>
</date>
</history>
<permissions><copyright-statement>Copyright © 2019 Liu, Zhang, Zhao, Liu, Hu and Dong</copyright-statement>
<copyright-year>2019</copyright-year>
<copyright-holder>Liu, Zhang, Zhao, Liu, Hu and Dong</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/"><license-p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.</license-p>
</license>
</permissions>
<abstract><p>Lower respiratory tract infections (LRTIs) refer to the inflammation of the trachea, bronchi, bronchioles, and lung tissue. Old people have an increased risk of developing LRTIs compared to young adults. The prevalence of LRTIs in the elderly population is not only related to underlying diseases and aging itself, but also to a variety of clinical issues, such as history of hospitalization, previous antibacterial therapy, mechanical ventilation, antibiotic resistance. These factors mentioned above have led to an increase in the prevalence and mortality of LRTIs in the elderly, and new medical strategies targeting LRTIs in this population are urgently needed. After a systematic review of the current randomized controlled trials and related studies, we recommend novel pharmacotherapies that demonstrate advantages for the management of LRTIs in people over the age of 65. We also briefly reviewed current medications for respiratory communicable diseases in the elderly. Various sources of information were used to ensure all relevant studies were included. We searched Pubmed, MEDLINE (OvidSP), EMBASE (OvidSP), and ClinicalTrials.gov. Strengths and limitations of these drugs were evaluated based on whether they have novelty of mechanism, favorable pharmacokinetic/pharmacodynamic profiles, avoidance of interactions and intolerance, simplicity of dosing, and their ability to cope with challenges which was mainly evaluated by the primary and secondary endpoints. The purpose of this review is to recommend the most promising antibiotics for treatment of LRTIs in the elderly (both in hospital and in the outpatient setting) based on the existing results of clinical studies with the novel antibiotics, and to briefly review current medications for respiratory communicable diseases in the elderly, aiming to a better management of LRTIs in clinical practice.</p>
</abstract>
<kwd-group><kwd>lower respiratory tract infections</kwd>
<kwd>elderly</kwd>
<kwd>controlled clinical trial</kwd>
<kwd>pharmacotherapy</kwd>
<kwd>antibiotics</kwd>
<kwd>drug resistance</kwd>
</kwd-group>
<counts><fig-count count="0"></fig-count>
<table-count count="2"></table-count>
<equation-count count="0"></equation-count>
<ref-count count="200"></ref-count>
<page-count count="18"></page-count>
<word-count count="9206"></word-count>
</counts>
</article-meta>
</front>
</pmc>
<affiliations><list><country><li>République populaire de Chine</li>
</country>
</list>
<tree><country name="République populaire de Chine"><noRegion><name sortKey="Liu, Yang" sort="Liu, Yang" uniqKey="Liu Y" first="Yang" last="Liu">Yang Liu</name>
</noRegion>
<name sortKey="Dong, Birong" sort="Dong, Birong" uniqKey="Dong B" first="Birong" last="Dong">Birong Dong</name>
<name sortKey="Dong, Birong" sort="Dong, Birong" uniqKey="Dong B" first="Birong" last="Dong">Birong Dong</name>
<name sortKey="Hu, Fengjuan" sort="Hu, Fengjuan" uniqKey="Hu F" first="Fengjuan" last="Hu">Fengjuan Hu</name>
<name sortKey="Hu, Fengjuan" sort="Hu, Fengjuan" uniqKey="Hu F" first="Fengjuan" last="Hu">Fengjuan Hu</name>
<name sortKey="Liu, Xiaolei" sort="Liu, Xiaolei" uniqKey="Liu X" first="Xiaolei" last="Liu">Xiaolei Liu</name>
<name sortKey="Liu, Xiaolei" sort="Liu, Xiaolei" uniqKey="Liu X" first="Xiaolei" last="Liu">Xiaolei Liu</name>
<name sortKey="Liu, Yang" sort="Liu, Yang" uniqKey="Liu Y" first="Yang" last="Liu">Yang Liu</name>
<name sortKey="Zhang, Yan" sort="Zhang, Yan" uniqKey="Zhang Y" first="Yan" last="Zhang">Yan Zhang</name>
<name sortKey="Zhang, Yan" sort="Zhang, Yan" uniqKey="Zhang Y" first="Yan" last="Zhang">Yan Zhang</name>
<name sortKey="Zhao, Wanyu" sort="Zhao, Wanyu" uniqKey="Zhao W" first="Wanyu" last="Zhao">Wanyu Zhao</name>
<name sortKey="Zhao, Wanyu" sort="Zhao, Wanyu" uniqKey="Zhao W" first="Wanyu" last="Zhao">Wanyu Zhao</name>
</country>
</tree>
</affiliations>
</record>
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