@article{baclet_explicit_2022,
	title = {Explicit definitions of potentially inappropriate prescriptions of antibiotics in hospitalized older patients},
	issn = {26669919},
	url = {https://linkinghub.elsevier.com/retrieve/pii/S2666991922000379},
	doi = {10.1016/j.idnow.2022.02.004},
	language = {en},
	urldate = {2022-02-24},
	journal = {Infectious Diseases Now},
	author = {Baclet, N and Calafiore, M and Fregnac, C and Gavazzi, G and Forestier, E and Roubaud-Baudron, C and Fraisse, T and Alfandari, S and Senneville, E and Beuscart, J-B},
	month = feb,
	year = {2022},
	pages = {S2666991922000379},
}

@article{forestier_managing_2021,
	title = {Managing infective endocarditis in older patients: do we need a geriatrician?},
	volume = {33},
	issn = {1720-8319},
	shorttitle = {Managing infective endocarditis in older patients},
	url = {http://link.springer.com/10.1007/s40520-019-01400-6},
	doi = {10.1007/s40520-019-01400-6},
	language = {en},
	number = {3},
	urldate = {2022-02-24},
	journal = {Aging Clinical and Experimental Research},
	author = {Forestier, Emmanuel and Selton-Suty, Christine and Roubaud-Baudron, Claire},
	month = mar,
	year = {2021},
	pages = {719--722},
}

@article{caraux-paz_tuberculosis_2021,
	title = {Tuberculosis in the {Elderly}},
	volume = {10},
	issn = {2077-0383},
	url = {https://www.mdpi.com/2077-0383/10/24/5888},
	doi = {10.3390/jcm10245888},
	abstract = {The tuberculosis (TB) epidemic is most prevalent in the elderly, and there is a progressive increase in the notification rate with age. Most cases of TB in the elderly are linked to the reactivation of lesions that have remained dormant. The awakening of these lesions is attributable to changes in the immune system related to senescence. The mortality rate from tuberculosis remains higher in elderly patients. Symptoms of active TB are nonspecific and less pronounced in the elderly. Diagnostic difficulties in the elderly are common in many diseases but it is important to use all possible techniques to make a microbiological diagnosis. Recognising frailty to prevent loss of independence is a major challenge in dealing with the therapeutic aspects of elderly patients. Several studies report contrasting data about poorer tolerance of TB drugs in this population. Adherence to antituberculosis treatment is a fundamental issue for the outcome of treatment. Decreased completeness of treatment was shown in older people as well as a higher risk of treatment failure.},
	language = {en},
	number = {24},
	urldate = {2022-02-24},
	journal = {Journal of Clinical Medicine},
	author = {Caraux-Paz, Pauline and Diamantis, Sylvain and de Wazières, Benoit and Gallien, Sébastien},
	month = dec,
	year = {2021},
	pages = {5888},
}

The tuberculosis (TB) epidemic is most prevalent in the elderly, and there is a progressive increase in the notification rate with age. Most cases of TB in the elderly are linked to the reactivation of lesions that have remained dormant. The awakening of these lesions is attributable to changes in the immune system related to senescence. The mortality rate from tuberculosis remains higher in elderly patients. Symptoms of active TB are nonspecific and less pronounced in the elderly. Diagnostic difficulties in the elderly are common in many diseases but it is important to use all possible techniques to make a microbiological diagnosis. Recognising frailty to prevent loss of independence is a major challenge in dealing with the therapeutic aspects of elderly patients. Several studies report contrasting data about poorer tolerance of TB drugs in this population. Adherence to antituberculosis treatment is a fundamental issue for the outcome of treatment. Decreased completeness of treatment was shown in older people as well as a higher risk of treatment failure.

@article{hernandez-ruiz_subcutaneous_2021,
	title = {Subcutaneous {Antibiotic} {Therapy}: {The} {Why}, {How}, {Which} {Drugs} and {When}},
	volume = {22},
	issn = {15258610},
	shorttitle = {Subcutaneous {Antibiotic} {Therapy}},
	url = {https://linkinghub.elsevier.com/retrieve/pii/S1525861020303637},
	doi = {10.1016/j.jamda.2020.04.035},
	language = {en},
	number = {1},
	urldate = {2022-02-24},
	journal = {Journal of the American Medical Directors Association},
	author = {Hernández-Ruiz, Virgilio and Forestier, Emmanuel and Gavazzi, Gaëtan and Ferry, Tristan and Grégoire, Nicolas and Breilh, Dominique and Paccalin, Marc and Goutelle, Sylvain and Roubaud-Baudron, Claire},
	month = jan,
	year = {2021},
	pages = {50--55.e6},
}

@article{durand_determinants_2021,
	title = {Determinants of doctors’ antibiotic prescriptions for patients over 75 years old in the terminal stage of palliative care},
	volume = {51},
	issn = {26669919},
	url = {https://linkinghub.elsevier.com/retrieve/pii/S0399077X2030740X},
	doi = {10.1016/j.medmal.2020.10.013},
	language = {en},
	number = {4},
	urldate = {2022-02-24},
	journal = {Infectious Diseases Now},
	author = {Durand, M. and Forestier, E. and Gras Aygon, C. and Sirvain, S. and de Wazières, B. and Bernard, L. and Paccalin, M. and Legout, L. and Roubaud Baudron, C. and Gavazzi, G. and Fraisse, T.},
	month = jun,
	year = {2021},
	pages = {340--345},
}

@article{sirvain_antibiotics_2021,
	title = {Antibiotics in end of life: {The} driving factors},
	issn = {26669919},
	shorttitle = {Antibiotics in end of life},
	url = {https://linkinghub.elsevier.com/retrieve/pii/S2666991921005169},
	doi = {10.1016/j.idnow.2021.10.004},
	language = {en},
	urldate = {2022-02-24},
	journal = {Infectious Diseases Now},
	author = {Sirvain, Serge and Durand, Mailys and Putot, Alain and Forestier, Emmanuel and Gavazzi, Gaetan and Fraisse, Thibaut},
	month = oct,
	year = {2021},
	pages = {S2666991921005169},
}

@article{forestier_comprehensive_2019,
	title = {Comprehensive geriatric assessment in older patients suffering from infective endocarditis. {A} prospective multicentric cohort study},
	volume = {25},
	issn = {1198743X},
	url = {https://linkinghub.elsevier.com/retrieve/pii/S1198743X19301983},
	doi = {10.1016/j.cmi.2019.04.021},
	language = {en},
	number = {10},
	urldate = {2022-02-24},
	journal = {Clinical Microbiology and Infection},
	author = {Forestier, E. and Roubaud-Baudron, C. and Fraisse, T. and Patry, C. and Gavazzi, G. and Hoen, B. and Carauz-Paz, P. and Moheb-Khosravi, B. and Delahaye, F. and Sost, G. and Paccalin, M. and Nazeyrollas, P. and Strady, C. and Alla, F. and Selton-Suty, C. and Schambach, S. and Vallette, d’O. and Khosravi, B.M. and Patry, C. and Roubaud, C. and Lafargue, A. and Guerville, F. and Kobeh, D. and Averty, E. and Thiennaud, L. and Soulas, E. and Gavazzi, G. and Basileu, T. and Chuzeville, M. and Laurain, M.-C. and Paccalin, M. and Novella, J.L. and Bertholon, L.A. and Jaidi, Y. and Guiard, R. and Sost, G. and Naturel, J. and Fraisse, T. and Vitrat, V. and Duval, X. and Wirth, G. and Forestier, E. and Pavese, P. and Pierre, I. and Hoen, B. and Fernandes, É. and Curlier, E. and Boibieux, A. and Goehringer, F. and Béraud, G. and Nguyen, Y. and Strady, C. and Tattevin, P. and Revest, M. and Piau, C. and Paz, P.C. and Vançon, A.-C. and Naem, N. and Richard, B. and Iung, B. and Dijos, M. and Fluttaz, A. and Ennezat, P.-V. and Delahaye, F. and Selton-Suty, C. and Beaufort, C. and Nazeyrollas, P. and Torossian, F. and Brasselet, C. and Donal, E. and Pineau, O. and Alla, F. and Agrinier, N. and Erpelding, M.-L. and Sime, W.N. and Clavère, G. and Lebouc, M. and Ilic-Habensus, E. and Durrieu, J. and Habet, T. and Dupré, C. and Chaissac, A.-M. and Touati, S. and Delahaye, A. and Marquis, E. and Warchol, M. and Thébault, E. and Jouan, C. and Campagnac, C. and Petitgenêt, I.},
	month = oct,
	year = {2019},
	pages = {1246--1252},
}

@article{roubaud-baudron_tolerance_2017,
	title = {Tolerance of subcutaneously administered antibiotics: a {French} national prospective study},
	volume = {46},
	issn = {1468-2834},
	shorttitle = {Tolerance of subcutaneously administered antibiotics},
	doi = {10.1093/ageing/afw143},
	abstract = {BACKGROUND/ OBJECTIVE: Although poorly documented, subcutaneous (SC) administration of antibiotics is common practice in France especially in Geriatrics Departments. The aim of this study was to determine the tolerance of such a practice.
DESIGN: Prospective observational multicentre study.
METHODS: Sixty-six physicians accepted to participate from 50 French Infectious Diseases and Geriatrics Departments. From May to September 2014, patients treated at least one day with SC antibiotics could be included. Modalities of subcutaneous administration, occurrence of local and systemic adverse effects (AE) and clinical course were collected until the end of the treatment.
RESULTS: Two hundred-nineteen patients (83.0 [19–104] yo) were included. Ceftriaxone (n = 163, 74.4\%), and ertapenem (n = 30, 13.7\%) were the most often prescribed antibiotics. The SC route was mainly used because of poor venous access (65.3\%) and/or palliative care (32.4\%). Fifty patients (22.8\%) experienced at least one local AE that led to an increased hospital stay for two patients (4.0\%) and a discontinuation of the SC infusion in six patients (12.0\%). A binary logistic regression for multivariate analysis identified the class of antibiotic (p = 0.002) especially teicoplanin and the use of rigid catheter (p = 0.009) as factors independently associated with AE. In over 80\% of cases, SC antibiotics were well tolerated and associated with clinical recovery.
CONCLUSIONS: SC administration of antibiotics leads to frequent but local and mild AE. Use of non-rigid catheter appears to be protective against AE. As it appears to be a safe alternative to the intravenous route, more studies are needed regarding efficacy and pharmacokinetics.},
	language = {eng},
	number = {1},
	journal = {Age and Ageing},
	author = {Roubaud-Baudron, Claire and Forestier, Emmanuel and Fraisse, Thibaut and Gaillat, Jacques and de Wazières, Benoit and Pagani, Leonardo and Ingrand, Isabelle and Bernard, Louis and Gavazzi, Gaëtan and Paccalin, Marc},
	month = jan,
	year = {2017},
	pmid = {28181635},
	keywords = {Adult, Aged, Aged, 80 and over, Anti-Bacterial Agents, Bacterial Infections, Catheters, Drug Administration Schedule, Drug-Related Side Effects and Adverse Reactions, Equipment Design, Female, France, Humans, Infusions, Subcutaneous, Logistic Models, Male, Middle Aged, Multivariate Analysis, Odds Ratio, Prospective Studies, Risk Factors, Time Factors, Young Adult},
	pages = {151--155},
}

BACKGROUND/ OBJECTIVE: Although poorly documented, subcutaneous (SC) administration of antibiotics is common practice in France especially in Geriatrics Departments. The aim of this study was to determine the tolerance of such a practice. DESIGN: Prospective observational multicentre study. METHODS: Sixty-six physicians accepted to participate from 50 French Infectious Diseases and Geriatrics Departments. From May to September 2014, patients treated at least one day with SC antibiotics could be included. Modalities of subcutaneous administration, occurrence of local and systemic adverse effects (AE) and clinical course were collected until the end of the treatment. RESULTS: Two hundred-nineteen patients (83.0 [19–104] yo) were included. Ceftriaxone (n = 163, 74.4%), and ertapenem (n = 30, 13.7%) were the most often prescribed antibiotics. The SC route was mainly used because of poor venous access (65.3%) and/or palliative care (32.4%). Fifty patients (22.8%) experienced at least one local AE that led to an increased hospital stay for two patients (4.0%) and a discontinuation of the SC infusion in six patients (12.0%). A binary logistic regression for multivariate analysis identified the class of antibiotic (p = 0.002) especially teicoplanin and the use of rigid catheter (p = 0.009) as factors independently associated with AE. In over 80% of cases, SC antibiotics were well tolerated and associated with clinical recovery. CONCLUSIONS: SC administration of antibiotics leads to frequent but local and mild AE. Use of non-rigid catheter appears to be protective against AE. As it appears to be a safe alternative to the intravenous route, more studies are needed regarding efficacy and pharmacokinetics.

@article{forestier_managing_2016,
	title = {Managing infective endocarditis in the elderly: new issues for an old disease},
	volume = {11},
	issn = {1178-1998},
	shorttitle = {Managing infective endocarditis in the elderly},
	doi = {10.2147/CIA.S101902},
	abstract = {The incidence of infective endocarditis (IE) rises in industrialized countries. Older people are more affected by this severe disease, notably because of the increasing number of invasive procedures and intracardiac devices implanted in these patients. Peculiar clinical and echocardiographic features, microorganisms involved, and prognosis of IE in elderly have been underlined in several studies. Additionally, elderly population appears quite heterogeneous, from healthy people without past medical history to patients with multiple diseases or who are even bedridden. However, the management of IE in this population has been poorly explored, and international guidelines do not recommend adapting the therapeutic strategy to the patient's functional status and comorbidities. Yet, if IE should be treated according to current recommendations in the healthiest patients, concerns may rise for older patients who suffer from several chronic diseases, especially renal failure, and are on polypharmacy. Treating frailest patients with high-dose intravenous antibiotics during a prolonged hospital stay as recommended for younger patients could also expose them to functional decline and toxic effect. Likewise, the place of surgery according to the aging characteristics of each patient is unclear. The aim of this article is to review the recent data on epidemiology of IE and its peculiarities in the elderly. Then, its management and various therapeutic approaches that can be considered according to and beyond guidelines depending on patient comorbidities and frailty are discussed.},
	language = {eng},
	journal = {Clinical Interventions in Aging},
	author = {Forestier, Emmanuel and Fraisse, Thibaut and Roubaud-Baudron, Claire and Selton-Suty, Christine and Pagani, Leonardo},
	year = {2016},
	pmid = {27621607},
	pmcid = {PMC5015881},
	keywords = {Aged, Aged, 80 and over, Anti-Bacterial Agents, Cardiac Surgical Procedures, Comorbidity, Disease Management, Endocarditis, Frail Elderly, Humans, Incidence, Practice Guidelines as Topic, Risk Factors, antibiotic therapy, cardiac surgery, elderly, frailty, infective endocarditis},
	pages = {1199--1206},
}

The incidence of infective endocarditis (IE) rises in industrialized countries. Older people are more affected by this severe disease, notably because of the increasing number of invasive procedures and intracardiac devices implanted in these patients. Peculiar clinical and echocardiographic features, microorganisms involved, and prognosis of IE in elderly have been underlined in several studies. Additionally, elderly population appears quite heterogeneous, from healthy people without past medical history to patients with multiple diseases or who are even bedridden. However, the management of IE in this population has been poorly explored, and international guidelines do not recommend adapting the therapeutic strategy to the patient's functional status and comorbidities. Yet, if IE should be treated according to current recommendations in the healthiest patients, concerns may rise for older patients who suffer from several chronic diseases, especially renal failure, and are on polypharmacy. Treating frailest patients with high-dose intravenous antibiotics during a prolonged hospital stay as recommended for younger patients could also expose them to functional decline and toxic effect. Likewise, the place of surgery according to the aging characteristics of each patient is unclear. The aim of this article is to review the recent data on epidemiology of IE and its peculiarities in the elderly. Then, its management and various therapeutic approaches that can be considered according to and beyond guidelines depending on patient comorbidities and frailty are discussed.