INFECTIOUS DISEASE CONSULTATIONS IN HOSPITALIZED ELDERLY PATIENTS

Introduction: The aim of this study was to investigate the various features of infectious disease consultations, antibiotic usage before and after consultations and adherence to the recommendations of the infectious disease physicians in hospitalized elderly patients. Materials and Method: This retrospective study was conducted in Zonguldak Karaelmas University Teaching and Research Hospital. Hospitalized patients aged 65 years and over for whom an infectious disease consultation was requested between January 2010 and January 2011 were included in the study. Results: The most common causes of consultation requests were the presence of high fever alone, leukocytosis alone, infiltration on chest X-ray, and skin and soft tissue infections. The most commonly diagnosed infections by the infectious disease physicians were community-acquired pneumonias, nosocomial pneumonias and urinary tract infections. In 99 patients, empirical antimicrobial therapy was initiated prior to the infectious disease consultation request, and the most commonly used antibiotics were third-generation cephalosporins and ciprofloxacin ampicillin-sulbactam. The most common antimicrobial regimens initiated after the consultation were carbapenems, piperacillin-tazobactam and cefoperazone-sulbactam. The mortality rate of the patients in whom the initiated antibiotic treatment regimens were broadened was significantly higher than the mortality rate of the patients in whom the treatment regimens were not changed and in patients whose treatment was initiated by the infectious disease physicians. Adherence to the recommendations was complete in 292 of 303 consultations. Conclusion: The empirical treatment of hospitalized elderly patients may include broader spectrum antibiotics. Adherence to the recommendations of the infectious disease team may help solve serious and complex infectious problems.