Ceftazidime is a third-generation cephalosporin used for the treatment of Gram-negative bacteria only approved for parenteral use by intravenous and intramuscular route. In some clinical situations, off-label subcutaneous injection could be a salvage route for the administration of antibiotics, especially in geriatrics, despite the paucity of evidence about efficacy and safety. We report a case of a successful and well-tolerated subcutaneous ceftazidime therapy in a 90-year-old woman for the treatment of an acute urinary tract infection caused by Pseudomonas aeruginosa with therapeutic drug monitoring data.
Anti-Bacterial Agents/administration & dosage , Ceftazidime/administration & dosage , Pseudomonas Infections/drug therapy , Urinary Tract Infections/drug therapy , Aged, 80 and over , Anti-Bacterial Agents/adverse effects , Anti-Bacterial Agents/pharmacokinetics , Ceftazidime/adverse effects , Ceftazidime/pharmacokinetics , Drug Monitoring , Female , Humans , Injections, Subcutaneous , Off-Label Use , Pseudomonas Infections/diagnosis , Pseudomonas Infections/microbiology , Salvage Therapy , Treatment Outcome , Urinary Tract Infections/diagnosis , Urinary Tract Infections/microbiology
Hospitalization in the elderly patients is highly associated with morbi-mortality. Geriatric post-acute and rehabilitation care wards are designed to provide care and to implement life project of elderly patients. Objective of this study was to characterize rehospitalizations after a stay in geriatric post-acute and rehabilitation care wards. METHODS: The study was retrospective, case-control, including all the patients hospitalized in the 4 geriatric post-acute and rehabilitation care wards of a hospital in Paris (France) and returned at home. Data collection was carried out on the basis of the hospitalization report and the information system of the hospital. Rehospitalizations were documented by the information system as well as by telephone interview. We compared patients according to whether they had been rehospitalized or not within 60 days after discharge. RESULTS: Out of a total of 1,063 stays during a 12 months period, 435 (41%) were discharged at home. Re-admission rate was 10.1% at 30 days and 18.4% at 90 days. Mean age of rehospitaliszed patients was 87.2 years ± 5.3 vs 87.9 years ± 5.8 for non-rehospitalized patients. Patients rehospitalized had more often a delirium during the prior hospitalization. CONCLUSION: Unplanned rehospitalisation is a major public health issue and should be prevented particularly after a stay in a geriatric post-acute and rehabilitation care wards.
Geriatrics/statistics & numerical data , Hospital Departments/statistics & numerical data , Patient Readmission/statistics & numerical data , Age Factors , Aged , Aged, 80 and over , Case-Control Studies , Female , Forecasting , Humans , Length of Stay , Male , Paris/epidemiology , Rehabilitation , Retrospective Studies
