Age and comorbidities vs choice of antibiotics

Annette Kurrle, MD, is a geriatric coordinator at Community Hospital Mittelrhein in Germany, scientific associate at the University of Mainz, and member of the European Federation of Internal Medicine Multimorbidity Working Group.

Should age and comorbidities be taken into account when making decisions about the choice of antibiotics? In which situations?

Annette Kurrle, MD: Age and comorbidities are always necessary to be involved in the choice of antibiotic therapy, but I think we have to differentiate. On the one hand, we have antibiotics that are not recommended for old people, and we must pay attention to this point. Then, we must differentiate what kind of infection it is. Is this a very serious, life-threatening infection or is it a slight infection? In the case of a serious infection or a septic process, again, we have recommendations, but there is the survival aspect, and in elderly people we have to show what the life expectancy is. Is the fact that there is the infection too much regarding the other comorbidities and multimorbidity? There is no general answer, but it’s an individual decision we have to make.