Abstract
Acute respiratory infections (ARIs) are one of the main causes of morbidity, functional impairment, and mortality in institutionalised older adults. This group is highly vulnerable due to factors such as advanced age, multimorbidity, frailty, and structural barriers to infection prevention and control. This article reviews, in a question-and-answer format, the most recent evidence on the epidemiology, prevention and treatment of the most relevant respiratory infections in nursing homes: influenza, SARS-CoV-2, respiratory syncytial virus, and Streptococcus pneumoniae. Epidemiological changes after the COVID-19 pandemic, current vaccination strategies, the efficacy and characteristics of newly vaccines available, as well as the updated therapeutic approach according to resistance profiles and the availability of antivirals, are analysed. In addition, the clinical and functional impact that these infections can have on residents is addressed, as well as the need to find a balance between preventive measures and the quality of life of this population group. The importance of effective coordination between health and social care professionals, and the implementation of protocols adapted to the residential context is highlighted. The article provides practical, evidence-based recommendations to improve the prevention and treatment of these infections in a particularly vulnerable environment.