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[Urinary tract infections in the elderly].

J Hervé1, A Santin, E Hinglais

  • 1Service des Urgences, Hôpital Henri Mondor, F 94010 Créteil.

Presse Medicale (Paris, France : 1983)
|February 24, 2001
PubMed
Summary

Routine urine tests are not recommended for elderly individuals due to risks of misdiagnosis and antibiotic resistance. Diagnosis of urinary tract infections requires careful evaluation, and antibiotic treatment must be tailored to individual kidney function.

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Area of Science:

  • Geriatrics
  • Infectious Diseases
  • Urology

Context:

  • Urinary tract infections (UTIs) are more common in individuals over 65.
  • Comorbidities, living conditions, and cognitive changes in the elderly influence UTI presentation and pathogens.
  • Altered urinary function can lead to atypical clinical symptoms.

Purpose:

  • To review the literature on urinary tract infections in the elderly.
  • To evaluate the utility of systematic screening for asymptomatic bacteriuria in this population.
  • To provide guidance on appropriate diagnostic and treatment strategies for UTIs in older adults.

Summary:

  • Systematic screening for asymptomatic bacteriuria in the elderly is generally not warranted.
  • Such screening can lead to germ selection and incorrect diagnoses.

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  • Diagnosis of UTIs should be evidence-based, considering patient history and differential diagnoses.
  • Antibiotic therapy must be individualized, considering kidney function and clinical context.

    • Impact:

    • Discourages unnecessary antibiotic use in the elderly, reducing resistance.
    • Promotes accurate diagnosis of symptomatic UTIs.
    • Emphasizes personalized antibiotic selection and dosing based on renal function.
    • Contributes to improved management of UTIs in geriatric populations.