Older Americans Are Awash in Antibiotics

By Paula Span: For More Info, Go Here…

The drugs are not just overprescribed. They often pose special risks to older patients, including tendon problems, nerve damage and mental health issues.

Last month, Caryn Isaacs went to see her primary care doctor for her annual Medicare wellness visit. A patient advocate who lives in Manhattan, Ms. Isaacs, 68, felt perfectly fine and expected a clean bill of health.

But her doctor, who’d ordered a variety of blood and urine tests, said she had a urinary tract infection and prescribed an antibiotic.

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

There are actually plenty of reasons for older people to avoid Cipro and other antibiotics known as fluoroquinolones, which have prompted warnings from the Food and Drug Administration about their risks of serious side effects.

And there are good reasons to avoid any antibiotic when bacteria are detected in a urine culture in a patient who has no other signs of infection. So-called asymptomatic bacteriuria increases with age, but these women are not sick and don’t need drugs, so medical guidelines recommend against routine screening or treatment.

Yet Ms. Isaac’s prescription was hardly unusual. Despite ongoing campaigns by the Centers for Disease Control and Prevention and other public health groups, older Americans still take too many antibiotics.

Patients over age 65 have the highest rate of outpatient prescribing of any age group. A new C.D.C. study, published in the Journal of the American Geriatrics Society, points out that doctors write enough antibiotic prescriptions annually — nearly 52 million in 2014 — for every older person to get at least one.

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