Infections in Older Adults: A Case-Based Discussion Series Emphasizing Antibiotic Stewardship

Research output: Contribution to journalArticle


  • Alyson Michener
  • Barbara Heath
  • Christopher J. Crnich
  • Rebekah Moehring
  • Kenneth Schmader
  • Lona Mody
  • Westyn Branch-Elliman
  • Robin L.P. Jump

External Institution(s)

  • Case Western Reserve University
  • Department of Veterans Affairs
  • William S. Middleton VA Hospital
  • University of Wisconsin-Madison
  • Duke University
  • Duke University Medical Center
  • University of Michigan Health Systems
  • Louis Stokes Cleveland Veterans Affairs Medical Center


Original languageEnglish (US)
Number of pages1
JournalMedEdPORTAL : the journal of teaching and learning resources
StatusPublished - Sep 21 2018


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.

    Research areas

  • Antibiotic Stewardship, Antimicrobial Stewardship, Asymptomatic Bacteriuria, Bronchitis, Cellulitis, Clostridium Difficile Infection, Clostridium Infections, Editor's Choice, Nursing Homes, Older Adults, Pneumonia, Urinary Tract Infections

Citation formats


Michener, A., Heath, B., Crnich, C. J., Moehring, R., Schmader, K., Mody, L., ... Jump, R. L. P. (2018). Infections in Older Adults: A Case-Based Discussion Series Emphasizing Antibiotic Stewardship. MedEdPORTAL : the journal of teaching and learning resources, 14.


Michener, A, Heath, B, Crnich, CJ, Moehring, R, Schmader, K, Mody, L, Branch-Elliman, W & Jump, RLP 2018, 'Infections in Older Adults: A Case-Based Discussion Series Emphasizing Antibiotic Stewardship', MedEdPORTAL : the journal of teaching and learning resources, vol. 14.