Hospital-acquired infections cause considerable morbidity and mortality in elderly patients and burden the individual patient as well as the economy of society. Although these infections are linked to biological factors in elderly patients, there is a potential for increased prevention efforts. Changes in antibiotic policy and organisational tasks can reduce the spread of drug resistant bacteria causing serious nosocomial infections. Transmission of pathogens from hospitals to nursing homes and vice versa poses a particular challenge when dealing with elderly colonized or infected patients.