title: [Adequacy to the recommendations in urinary tract infections: a multicenter transversal survey in hospitalized patients aged over 75 years].
abstract: French diagnostic and therapeutic recommendations about UI were built-up in 2008. We studied clinician's practices and evaluated the adequacy to the recommendations in hospitalized patients aged over 75 years.
  
  
  METHODS
  Multicenter survey in acute care of geriatric, internal medicine and infectious disease wards. During one week, all positive urine cultures of patients over 75 were reported to the local investigator who had to fill out a questionnaire. The data specified the final diagnosis: cystitis, pyelonephritis, prostatitis, or colonization, the antibiotic treatment, the re-evaluation after 72 hours of treatment, the association with another infectious diagnosis and the radiological examinations performed.
  
  
  RESULTS
  241 questionnaires were collected from 48 wards. Colonization, cystitis, pyelonephritis and prostatitis were diagnosed respectively in 42, 27, 20 and 11% of urine cultures. In 48% of cystitis cases, the duration of treatment was inadequate. In 77% cases of pyelonephritis, the antibiotic was adapted to the recommendations, but 44% of patients had no further radiological examination. In cases of prostatitis antibiotic therapy was adequate in 74% of cases but often with a non-conform duration of treatment (56%) and absence of further radiographic examination (70%). The reassessment of the treatment at day 3 ranged from 63 to 88%. In 26% of UI diagnosis, another associated infection was described, mainly bronchopneumonia (56%).
  
  
  CONCLUSIONS
  Progress is needed to optimize treatment revaluation at 72 hours and adequate duration of treatment. The association of UI and bronchopneumonia is questionable. More specific recommendations would probably be useful to optimize the management of UI in the elderly.
authors.affiliation: Service de gériatrie, CHU de Poitiers.
authors.forename: Bertrand
authors.initials: B
authors.lastname: Fougère
authors.forename: Jacques
authors.initials: J
authors.lastname: Gaillat
authors.forename: Patrice
authors.initials: P
authors.lastname: François
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Cambau
authors.forename: Bénédicte
authors.initials: B
authors.lastname: Corroyer
authors.forename: Benoît
authors.initials: B
authors.lastname: de Wazières
authors.forename: Gaëtan
authors.initials: G
authors.lastname: Gavazzi
authors.forename: Marc
authors.initials: M
authors.lastname: Paccalin
mesh_terms: D000359:Aftercare; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001437:Bacteriuria / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003556:Cystitis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005602:France; D019983:Guideline Adherence; D006748:Hospital Departments / Q000706:statistics & numerical data; D006760:Hospitalization; D006801:Humans; D008297:Male; D011472:Prostatitis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D011704:Pyelonephritis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D019984:Quality Indicators, Health Care / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014552:Urinary Tract Infections / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D014567:Urography
chemical_list: D000900:Anti-Bacterial Agents