Older Americans Are Awash in Antibiotics

Older Americans(əˈmerəkən) Are Awash(əˈwäSH,əˈwôSH) in Antibiotics(ˌantēbīˈätik)

The drugs(drəg) are not just overprescribed(ˌōvərprəˈskrīb). They often pose(pōz) special risks to older patients, including tendon(ˈtendən) problems, nerve(nərv) damage(ˈdamij) and mental(ˈmentl) health issues(ˈiSHo͞o).

By Paula Span

Last month, Caryn Isaacs went to see her primary(ˈprīm(ə)rē,ˈprīˌmerē) care doctor for her annual(ˈanyo͞oəl) Medicare(ˈmediˌke(ə)r) wellness visit. A patient advocate(ˈadvəkət) who lives in Manhattan(manˈhatn,mən-), Ms. Isaacs, 68, felt perfectly fine and expected a clean bill of health.

But her doctor, who’d ordered a variety(vəˈrīətē) of blood(bləd) and urine(ˈyo͝orən) tests, said she had a urinary(ˈyo͝orəˌnerē) tract(trakt) infection(inˈfekSHən) and prescribed(prəˈskrīb) an antibiotic.

“The nurse(nərs) said, ‘Can you take Cipro?’” Ms. Isaacs recalled. “I didn’t have any reason not to, so I said yes.”

There are actually plenty(ˈplen(t)ē) of reasons for older people to avoid Cipro and other antibiotics known as fluoroquinolones(ˌflo͝orōˈkwinlˌōn,ˌflôrō-), which have prompted(prämpt) warnings from the Food and Drug Administration(ədˌminəˈstrāSHən) about their risks of serious(ˈsi(ə)rēəs) side effects.

And there are good reasons to avoid any antibiotic when bacteria(ˌbakˈtirēəm) are detected(dəˈtekt) in a urine(ˈyo͝orən) culture in a patient who has no other signs of infection. So-called asymptomatic(ˌāsim(p)təˈmatik) bacteriuria(bakˌti(ə)rēˈyo͝orēə) increases with age, but these women(ˈwimin) are not sick(sik) and don’t need drugs, so medical guidelines recommend against routine(ro͞oˈtēn) screening or treatment.

Yet Ms. Isaac’s prescription(prəˈskripSH(ə)n) was hardly unusual. Despite(dəˈspīt) ongoing campaigns(kamˈpān) by the Centers for Disease(dəˈzēz) Control(kənˈtrōl) and Prevention(prəˈven(t)SH(ə)n) and other public health groups, older Americans still take too many antibiotics.

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https://www.nytimes.com/2019/03/15/health/antibiotics-elderly-risks.html?smid=nytcore-ios-share