Antibiotic use in older Australians with and without dementia in primary care.

Background Antibiotics are commonly prescribed in older community-dwelling adults, contributing to adverse effects, antimicrobial resistance and increased healthcare costs. Prescribing patterns in dementia are unclear, although healthcare use and goals of care change around diagnosis. Objective To d...

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Publicado en:Age & Ageing Vol. 55; no. 2; pp. 1 - 12
Autores principales: Burvenich, Ruben, Broder, Jonathan C, Wang, Yiqing, Verbakel, Jan Y, Ryan, Joanne, Orchard, Suzanne G, Wolfe, Rory, Ernst, Erika J, Ernst, Michael E, Nelson, Mark R
Formato: Artículo
Publicado: Oxford University Press / USA Feb2026
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Acceso en línea:Ver este registro en EBSCOhost
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      dt: Feb2026
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        10.1093/ageing/afag014
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        atl: Antibiotic use in older Australians with and without dementia in primary care.
      aug:
        au:
          Burvenich, Ruben
          Broder, Jonathan C
          Wang, Yiqing
          Verbakel, Jan Y
          Ryan, Joanne
          Orchard, Suzanne G
          Wolfe, Rory
          Ernst, Erika J
          Ernst, Michael E
          Nelson, Mark R
        affil:
          Department of Public Health and Primary Care, KU Leuven, Leuven, Flemish Brabant, BelgiumMenzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
          School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
          Clinical and Translational Epidemiology Unit, Harvard Medical School, Boston, MA, USA
          Department of Public Health and Primary Care, KU Leuven, Leuven, Flemish Brabant, Belgium
          Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa Health Care, Iowa City, IA, USA
          Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa Health Care, Iowa City, IA, USADepartment of Family Medicine, Carver College of Medicine, University of Iowa Health Care, Iowa City, IA, USA
          Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
      su:
        Australia
        Primary health care
        Sex distribution
        Hypertension
        Case-control method
        Psychological tests
        Alcohol drinking
        Mental depression
        Old age
        Diagnosis of dementia
        Antibiotics
        Risk assessment
        Mathematical variables
        Tetracyclines
        Hyperlipidemia
        Family medicine
        Medical prescriptions
        Research funding
        Statistical sampling
        Multiple regression analysis
        Antimicrobial stewardship
        Beta lactam antibiotics
        Frail elderly
        Disease prevalence
        Trend analysis
        Polypharmacy
        Time series analysis
        Descriptive statistics
        Intravenous therapy
        Longitudinal method
        Quinolone antibacterial agents
        Neuropsychological tests
        Medical records
        Acquisition of data
        Research
        Physician practice patterns
        Comparative studies
        Data analysis software
        Confidence intervals
        Drug prescribing
        Aminoglycosides
        Dementia patients
        Drug utilization
        Penicillin
      sug:
        subj:
          Primary health care
          Sex distribution
          Hypertension
          Case-control method
          Psychological tests
          Alcohol drinking
          Mental depression
          Old age
          Australia
          Pharmaceuticals and pharmacy supplies merchant wholesalers
          Drugs and Druggists' Sundries Merchant Wholesalers
          Pharmaceutical and medicine manufacturing
          Medicinal and Botanical Manufacturing
          Drinking Places (Alcoholic Beverages)
          Marketing Research and Public Opinion Polling
          Diagnosis of dementia
          Antibiotics
          Risk assessment
          Mathematical variables
          Tetracyclines
          Hyperlipidemia
          Family medicine
          Medical prescriptions
          Research funding
          Statistical sampling
          Multiple regression analysis
          Antimicrobial stewardship
          Beta lactam antibiotics
          Frail elderly
          Disease prevalence
          Trend analysis
          Polypharmacy
          Time series analysis
          Descriptive statistics
          Intravenous therapy
          Longitudinal method
          Quinolone antibacterial agents
          Neuropsychological tests
          Medical records
          Acquisition of data
          Research
          Physician practice patterns
          Comparative studies
          Data analysis software
          Confidence intervals
          Drug prescribing
          Aminoglycosides
          Dementia patients
          Drug utilization
          Penicillin
      keyword:
        antibiotic dispensing
        antibiotics
        antimicrobial stewardship
        australians
        copyrightHolder:British Geriatrics Society
        copyrightYear:2026
        dementia
        diagnosis
        general practice
        https://dx.doi.org/10.1093/ageing/afag014
        inLanguage:en
        older adult
        older adults
        publisher:Oxford University Press
        sameAs:https://pubmed.ncbi.nlm.nih.gov/41627308/
        antibiotic dispensing
        antibiotics
        antimicrobial stewardship
        australians
        copyrightHolder:British Geriatrics Society
        copyrightYear:2026
        dementia
        diagnosis
        general practice
        https://dx.doi.org/10.1093/ageing/afag014
        inLanguage:en
        older adult
        older adults
        publisher:Oxford University Press
        sameAs:https://pubmed.ncbi.nlm.nih.gov/41627308/
      ab: Background Antibiotics are commonly prescribed in older community-dwelling adults, contributing to adverse effects, antimicrobial resistance and increased healthcare costs. Prescribing patterns in dementia are unclear, although healthcare use and goals of care change around diagnosis. Objective To describe trends in antibiotic dispensing and prevalence amongst Australians aged ≥70 years, compare dispensing between those with and without dementia and identify factors associated with dispensing. Methods We analysed data from 13 659 ASPREE and ASPREE-XT participants (2010–20). Antibiotic dispensing was assessed using Pharmaceutical Benefits Scheme records, with rates stratified by age group. Interrupted time-series analysis compared dispensing rates and the proportion of broad- versus narrow-spectrum antibiotics dementia case and matched controls (matched on time since randomisation, age and sex). Negative binomial regression identified factors associated with dispensing. Results Dispensing rates increased to 1651 per 1000 person-years (95% CI: 1604–99) by year 9. Annual prevalence averaged 47%. Broad-spectrum antibiotics were dispensed twice as often as narrow-spectrum. Individuals with dementia had higher dispensing both before and after diagnosis, but dementia was not independently associated with dispensing (IRR 1.06, 95% CI: 0.95–1.18). Female sex, polypharmacy, pre-frailty and higher depressive symptom scores were linked to higher dispensing, whilst hypertension, dyslipidaemia and alcohol use were linked to lower dispensing. Conclusions Antibiotic dispensing in older adults remains high, dominated by broad-spectrum agents. Dementia was not independently associated with increased dispensing. Female sex, polypharmacy, pre-frailty and depressive symptoms identified groups who may benefit most from targeted antimicrobial stewardship interventions.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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