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Title: Bacteriuria - To Treat or Not to Treat? (Submitted by Heidi Teague, MD)

Category: Geriatrics

Keywords: UTI, infection, elderly, symptoms, antibiotics (PubMed Search)

Posted: 12/3/2017 by Danya Khoujah, MBBS

Asymptomatic bacteriuria is common and increases with age, with an incidence of up to 50% in women over the age of 70.  Asymptomatic bacteriuria does not carry an associated high morbidity or mortality if left untreated; it is usually transient and resolves spontaneously.  In order to decrease polypharmacy and possible drug interactions in our elderly patients, they should only be diagnosed with and treated for a UTI if they have laboratory evidence of a UTI (bacteriuria and pyuria) and have two of the following:

·      Fever

·      Worsened urinary urgency or frequency

·      Acute dysuria

·      Suprapubic tenderness

·      Costovertebral angle tenderness

References

Mody L, Juthani-Mehta M. Urinary Tract Infections in Older Women: A Clinical Review. JAMA. 2014;311(8):844-854. doi:10.1001/jama.2014.303.


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