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Antibiotics
Volume 15
Issue 5
10.3390/antibiotics15050496
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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Review

Sepsis in Frail Older Adults: Tailored Antimicrobial Stewardship and Individualized Care Approach

by
Elisa Fabbri
1,2,*,
Gianpiero Tebano
1,3,
Arianna de Angelis
3,
Annaviola Del Prete
2,
Lorenzo Maestri
2,
Francesco Cristini
1,3 and
Paolo Muratori
2,4
1
Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy
2
Division of Internal Medicine, Morgagni-Pierantoni Hospital, 47121 Forlì, Italy
3
Infectious Disease Unit, Morgagni-Pieratoni Hospital, 47121 Forlì, Italy
4
Department for Life Quality Studies, University of Bologna, 40126 Bologna, Italy
*
Author to whom correspondence should be addressed.
Antibiotics 2026, 15(5), 496; https://doi.org/10.3390/antibiotics15050496
Submission received: 2 April 2026 / Revised: 5 May 2026 / Accepted: 12 May 2026 / Published: 14 May 2026
(This article belongs to the Special Issue Antimicrobial Stewardship in Older Adults)
Versions Notes

Abstract

Frail older adults face an increased risk and severity of sepsis, which contributes to a notably high mortality rate. The management of sepsis in this population presents significant challenges, such as diagnostic complexity, a higher prevalence of multidrug-resistant pathogens, difficulties in achieving effective source control, and an increased risk of adverse events and toxicity associated with antibiotic therapy. In addition, accurate prognostic evaluation based on a comprehensive geriatric assessment is essential to determine the intensity of care required and to develop a personalized plan of care. Despite these considerations, frail older adults are still often underrepresented in randomized clinical trials and guidelines. In this narrative review, we discuss the main pillars of tailored antimicrobial stewardship in frail older adults. We propose a practical, stepwise approach to individualized care, delivered by a multidisciplinary team and based on a careful balance between treatment intensity and patients’ vulnerabilities, needs, and priorities.
Keywords: sepsis; older adults; frailty; antibiotics; antimicrobial stewardship sepsis; older adults; frailty; antibiotics; antimicrobial stewardship

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MDPI and ACS Style

Fabbri, E.; Tebano, G.; de Angelis, A.; Del Prete, A.; Maestri, L.; Cristini, F.; Muratori, P. Sepsis in Frail Older Adults: Tailored Antimicrobial Stewardship and Individualized Care Approach. Antibiotics 2026, 15, 496. https://doi.org/10.3390/antibiotics15050496

AMA Style

Fabbri E, Tebano G, de Angelis A, Del Prete A, Maestri L, Cristini F, Muratori P. Sepsis in Frail Older Adults: Tailored Antimicrobial Stewardship and Individualized Care Approach. Antibiotics. 2026; 15(5):496. https://doi.org/10.3390/antibiotics15050496

Chicago/Turabian Style

Fabbri, Elisa, Gianpiero Tebano, Arianna de Angelis, Annaviola Del Prete, Lorenzo Maestri, Francesco Cristini, and Paolo Muratori. 2026. "Sepsis in Frail Older Adults: Tailored Antimicrobial Stewardship and Individualized Care Approach" Antibiotics 15, no. 5: 496. https://doi.org/10.3390/antibiotics15050496

APA Style

Fabbri, E., Tebano, G., de Angelis, A., Del Prete, A., Maestri, L., Cristini, F., & Muratori, P. (2026). Sepsis in Frail Older Adults: Tailored Antimicrobial Stewardship and Individualized Care Approach. Antibiotics, 15(5), 496. https://doi.org/10.3390/antibiotics15050496

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