Successfully drug treatment for necrotizing fasciitis caused by Streptococcus pyogenes in 88-year-old patient.

Necrotizing fasciitis (NF) is a rare soft-tissue infection generally treated by emergency surgical intervention. We report a case of successfully drug treatment for NF in older patient with comorbidities thus avoiding surgical intervention.

Reassessment of Treatments in a Long-Term Care Unit.

The risks of iatrogenic medication related adverse events are high among older patients. Assessing prescriptions is critical to prevent overusing, underusing, or misusing medications. The aim of this study is to evaluate the prescription reassessment in older patients hospitalized in long-term care unit. Among the 30 patients (M age = 83 years, woman 66%), polymedication was present, patients taking 5 to 18 drugs (mean 11 drugs). The length of stay varied from 92 days to 4.5 years (mean 564 ± 430 days). The prescription reassessment of the patients hospitalized in our long-term care unit varied from 1 to 125 days with a mean of 16 days. Plan the prescription reassessment could reduce the iatrogenic medication in weakened patients.

Inappropriate proton pump inhibitor lansoprazole prescription in older adults hospitalized in long-term care unit.

PURPOSE: We evaluated the use of the PPI treatment by physicians in older adults hospitalized in a long-term care unit. METHODS: We included 40 patients aged 65 years or older with a lansoprazole prescription hospitalized in long-term care unit from January 2018 to January 2022. Patient characteristics, gastroduodenal history, dose of lansoprazole, indication, days of prescription, and number of medications were collected from electronic patient records. RESULTS: The mean age of patients was 84.2 ± 9.3. Patients were taking between 5 and 24 (mean = 12.7, SD = 4.4) medications overall with 15 patients taking low dose of aspirin (75 mg daily) and 8 patients taking an antiplatelet. Most patients (82.5%) received once-daily lansoprazole treatment, 55% of whom took a dose of 15 mg. Five patients were treated with the maximum dose of lansoprazole 30 mg twice daily. Only seven patients had an appropriate indication. The minimum of treatment time was 3 days and the maximum was 1198 days; moreover, 24 patients (60%) were still in treatment. CONCLUSION: Few PPI prescriptions had an indication in the patient's electronic record. Prescriptions were ongoing with no date of discontinuation or re-evaluation.

AIM: To evaluate the lansoprazole prescription in older adults hospitalized in long-term care unit. FINDINGS: In our study population of 65 years or more, the prevalence of appropriate prescription was 17.5% with mean of medications at 12.7 (SD = 4.4). The treatment time was ranging from 3 to 1198 days with 24 patients (60%) still in treatment. MESSAGE: Regular reassessment and the implementation of PPI prescription recommendations were still not routinely used in clinical practice.

Efficacy of Single Tocilizumab Administration in an 88-Year-Old Patient with Severe COVID-19 and a Mini Literature Review.

The new coronavirus disease 2019 (COVID-19) could be associated with elevated inflammatory cytokine levels, suggesting the involvement of cytokine release syndrome. This syndrome is characterized by release of interleukin 6 correlated with COVID-19 severity and mortality. Targeting IL-6 with Tocilizumab treatment could be a potential therapeutic option for old patients. We report the case of an 88-year-old man with COVID-19 disease who presented at the admission with anemia, fever, oxygen desaturation (92%), and inflammatory syndrome (C-reactive protein (CRP) at 182.5 mg/L; reference range <5.0 mg/L). After remaining CRP level increase (206.6 mg/L), Tocilizumab administration led to rapid clinical outcome and resolution of his inflammatory syndrome. This case report represents a supplementary data confirming the efficacy and safety of Tocilizumab for COVID-19 in elderly patients.