title: Optimal management of urinary tract infections in older people.
abstract: Urinary tract infections (UTI) occur frequently in older people. Unfortunately, UTI is commonly overdiagnosed and overtreated on the basis of nonspecific clinical signs and symptoms. The diagnosis of a UTI in the older patient requires the presence of new urinary symptoms, with or without systemic symptoms. Urinalysis is commonly used to diagnose infection in this population, however, the evidence for its use is limited. There is overwhelming evidence that asymptomatic bacteriuria should not be treated. Catheter associated urinary tract infection accounts for a significant amount of hospital-associated infection. Indwelling urinary catheters should be avoided where possible and alternatives sought. The use of narrow spectrum antimicrobial agents for urinary tract infection is advocated. Local guidelines are now widely used to reflect local resistance patterns and available agents. Guidelines need to be updated to reflect changes in antimicrobial prescribing and a move from broad to narrow spectrum antimicrobials.
authors.affiliation: Ageing and Health, Division of Medical Sciences, Ninewells Hospital and Medical School.
authors.forename: Louise A
authors.initials: LA
authors.lastname: Beveridge
authors.forename: Peter G
authors.initials: PG
authors.lastname: Davey
authors.forename: Gabby
authors.initials: G
authors.lastname: Phillips
authors.forename: Marion Et
authors.initials: ME
authors.lastname: McMurdo
mesh_terms: D000368:Aged; D001437:Bacteriuria / Q000175:diagnosis; D055499:Catheter-Related Infections / Q000517:prevention & control; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D016896:Treatment Outcome; D014552:Urinary Tract Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control