ABSTRACT
The overall approach to antimicrobial chemotherapy remains an important topic of practical and clinical significance. Antimicrobial agents are among the most widely prescribed drugs in long-term care facilities (LTCFs). An estimated one fifth of all LTCF residents receive an antimicrobial agent at any given time. Antimicrobial usage may seem disproportionately low compared to the 1.5 million infections observed in the long-term care setting annually (1), but indiscriminate prescribing of antimicrobial agents with lack of adequate documentation of infection, potential adverse drug reactions, and emergence of antimicrobial resistance are major concerns (2). Clinicians must thus exercise caution in their approach to antimicrobial prescription; vulnerable populations, for example elderly persons residing in LTCFs, need particular consideration because of the additional increased morbidity and mortality associated with age-related decline in immune function, debility, and comorbid illnesses (diabetes mellitus, cerebrovascular accidents, alcoholism, malnutrition, etc.). There should be a rational approach to an-
timicrobial prescribing in residents of LTCFs, with focus on age-related physiologic, pharmacokinetic, and pharmacodynamic changes that can affect the selection and dosing of such chemotherapeutic agents.
