Gastrointestinal infections are common in older adults, but the clinical presentation in the old may be atypical. The elderly have a suboptimal immune system, with a decline in T cell and B cell function, and a reduced T Cell CD28 expression. Proneness to infections is contributed to by decline in gastric acidity often by acid-neutralizing agents or stomach surgery. Infections due to opportunistic pathogens may not be recognized early, as the elderly are not considered immunocompromised. Antibiotics should be used judiciously; dose must be adjusted for renal and hepatic function. While inappropriate or excessive antimicrobial use can result in adverse effects such as Clostridium difficile infection, early empiric antimicrobials are indicated in select situations in older adults. Antibiotics must be used in conjunction with other measures, such as hemodynamic monitoring, fluids, and electrolyte replacement.
KeywordsClostridium Difficile Infection Hemolytic Uremic Syndrome Liver Abscess Shiga Toxin Gastrointestinal Infection
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