Infectious Diseases in Older Adults of Long-Term Care Facilities: Update on Approach to Diagnosis and Management

J Am Geriatr Soc. 2018 Apr;66(4):789-803. doi: 10.1111/jgs.15248.

Abstract

The diagnosis, treatment, and prevention of infectious diseases in older adults in long-term care facilities (LTCFs), particularly nursing facilities, remains a challenge for all health providers who care for this population. This review provides updated information on the currently most important challenges of infectious diseases in LTCFs. With the increasing prescribing of antibiotics in older adults, particularly in LTCFs, the topic of antibiotic stewardship is presented in this review. Following this discussion, salient points on clinical relevance, clinical presentation, diagnostic approach, therapy, and prevention are discussed for skin and soft tissue infections, infectious diarrhea (Clostridium difficile and norovirus infections), bacterial pneumonia, and urinary tract infection, as well as some of the newer approaches to preventive interventions in the LTCF setting.

Keywords: geriatrics; infections; infectious diseases; long-term care facilities; nursing facilities; nursing homes.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Aged
  • Anti-Bacterial Agents / therapeutic use*
  • Caliciviridae Infections / diagnosis
  • Caliciviridae Infections / therapy
  • Clostridium Infections / diagnosis
  • Clostridium Infections / therapy
  • Communicable Diseases / diagnosis*
  • Communicable Diseases / drug therapy*
  • Drug Resistance, Bacterial
  • Humans
  • Inappropriate Prescribing* / adverse effects
  • Inappropriate Prescribing* / prevention & control
  • Nursing Homes / statistics & numerical data*
  • Practice Guidelines as Topic / standards*
  • Urinary Tract Infections / diagnosis
  • Urinary Tract Infections / therapy

Substances

  • Anti-Bacterial Agents