Infections in Older Adults: A Case-Based Discussion Series Emphasizing Antibiotic Stewardship.
Abstract
Introduction:Compared with younger populations, adults 65 years and older are more
likely to suffer infection-related morbidity and mortality, experience antibiotic-related
adverse events, and acquire multidrug-resistant organisms. We developed a series of
case-based discussions that stressed antibiotic stewardship while addressing management
of common infections in older adults. Methods:Five 1-hour case-based discussions address
recognition, diagnosis, and management of infections common in older adults, including
those living in long-term care settings: urinary tract infections, upper respiratory
tract infections, lower respiratory tract infections, skin and soft tissue infections,
and Clostridium difficile infection. The education was implemented at the skilled
nursing centers at 15 Veterans Affairs medical centers. Participants from an array
of disciplines completed an educational evaluation for each session as well as a pre-
and postcourse knowledge assessment. Results:The number of respondents to the educational
evaluation administered following each session ranged from 68 to 108. Learners agreed
that each session met its learning objectives (4.80-4.89 on a 5-point Likert scale,
5 = strongly agree) and that they were likely to make changes (2.50-2.89 on a 3-point
scale, 3 = highly likely to make changes). The average score on the five-question
knowledge assessment increased from 3.6 (72%) to 3.9 (78%, p = .06). Discussion:By
stressing recognition of atypical signs and symptoms of infection in older adults,
diagnostic tests, and antibiotic stewardship, this series of five case-based discussions
enhanced clinical training of learners from several disciplines.
Type
Journal articleSubject
Antibiotic StewardshipAntimicrobial Stewardship
Asymptomatic Bacteriuria
Bronchitis
Cellulitis
Clostridium Difficile Infection
Clostridium Infections
Editor's Choice
Nursing Homes
Older Adults
Pneumonia
Urinary Tract Infections
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https://hdl.handle.net/10161/18186Published Version (Please cite this version)
10.15766/mep_2374-8265.10754Publication Info
Michener, Alyson; Heath, Barbara; Crnich, Christopher J; Moehring, Rebekah; Schmader,
Kenneth; Mody, Lona; ... Jump, Robin LP (2018). Infections in Older Adults: A Case-Based Discussion Series Emphasizing Antibiotic
Stewardship. MedEdPORTAL : the journal of teaching and learning resources, 14. pp. 10754. 10.15766/mep_2374-8265.10754. Retrieved from https://hdl.handle.net/10161/18186.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@Duke
Rebekah Moehring
Associate Professor of Medicine
Kenneth Edwin Schmader
Professor of Medicine
Dr. Schmader’s areas of research include herpes zoster, infections, and vaccines in
older adults. He conducts translational, clinical trials and observational studies
of zoster, influenza, and other infections funded by grants from the National Institute
on Aging (NIA), National Institute of Allergy and Infectious Diseases (NIAID), Centers
for Disease Control (CDC), VA Office of Research and Development, and Industry sources.
He has played a pivotal role in the development o
Alphabetical list of authors with Scholars@Duke profiles.

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