Complicated UTI. Effective treatment in the long-term care setting

Diagnosis and treatment of complicated urinary tract infection (UTI) in older persons in the long-term care setting presents practitioners with special clinical challenges and is a more complex proposition than management of UTIs that commonly arise in younger persons. Effective care is a function of consideration and understanding of several key issues relating to urinalysis, antibiotic therapy, duration of therapy, and the route of drug administration. Typical diagnostic and management hurdles include collecting a clean specimen; dealing effectively with asymptomatic bacteriuria, a benign condition that often precipitates unnecessary treatment; and appreciation that diagnosis should not be made based solely on a positive culture result.