When antimicrobials are indicated and consistent with an older person’s plan of care, intravenous formulations should not be the first choice unless there is no other safe and effective route of administration. Many antimicrobials have excellent bioavailability and only in rare instances need to be administered intravenously. Use of oral formulations of these medications reduces the need for placement and maintenance of venous access devices and their associated complications. In addition, reduced need for venous access can prevent transfer of an older person away from their current setting to accommodate a higher level of care.
Sources:
Association of Medical Microbiology and Infectious Disease. Five things physicians and patients should question in infectious disease [Internet]. 2017 Jun [cited 2019 Oct 4].
Centers for Disease Control and Prevention. Core Elements of Hospital Antibiotic Stewardship Programs [Internet]. 2014 [cited 2017 Oct 21].
Chapman, A. L., Patel, S., Horner, C., Green, H., Guleri, A., Hedderwick, S., … & Seaton, R. A. (2019). Updated good practice recommendations for outpatient parenteral antimicrobial therapy (OPAT) in adults and children in the UK. JAC-Antimicrobial Resistance, 1(2), dlz026.
The 2019 American Geriatrics Society Beers Criteria Update Expert Panel. American Geriatrics Society 2019 updated AGS Beers Criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2019 Apr;67(4):674-694. PMID: 30693946.
Toward Optimized Practice. Diagnosis and Management of Nursing Home Acquired Pneumonia [Internet].2015 Mar [cited 2018 January].
van Buul LW, et al. Antibiotic use and resistance in long term care facilities. J Am Med Dir Assoc. 2012 Jul;13(6):568.e1-13. PMID: 22575772.