[Pharmacotherapy in the geriatric intensive care patient: sedation and anti-infective treatment].

Older intensive care unit (ICU) patients are particularly vulnerable to adverse drug reactions, delirium, and treatment failure due to age-related changes in pharmacodynamics (PD) and pharmacokinetics (PK), compounded by the dynamic pathophysiology of critical illness. This review focuses on sedatives/analgesics and anti-infective agents. For analgosedation, an analgesia-first strategy, protocol-based light sedation (awake and cooperative whenever feasible), rigorous delirium management, and avoidance of continuous benzodiazepine infusions are recommended. In anti-infective therapy, key priorities include achieving PK/PD targets, daily dose adjustment to current drug clearance, de-escalation, and early therapeutic drug monitoring (vancomycin, aminoglycosides; selectively also β‑lactams).