Urinary tract infections in the elderly: a survey of physicians and nurses

The purpose of this study was to identify, in the presence of significant bacteriuria, the symptoms that determine and conditions that affect whether a physician will begin antibiotic treatment in the elderly; 2 physician groups were studied: geriatric physicians and family practice/internal medicine physicians. We also sought to compare these results to symptoms and conditions that determine nurses' decisions to begin assessment for urinary tract infections (UTIs) in this population. We also sought to determine the importance these 3 groups placed of monitoring asymptomatic bacteriuria for specific elderly patient populations. Quantitative questionnaires were sent to a convenience sample of 1900 physicians and nurses. Sixty-eight of the 300 geriatric physicians (23%), 113 of the 1000 family practice or internal medicine physicians (11%), and 192 of the 600 nurses (32%) returned surveys. Results showed differences between physician groups and nurses concerning whether cloudy and malodorous urine were symptoms of a UTI. This survey also found that physicians consider patient conditions to a greater extent than nurses do in their decisions regarding UTIs. Geriatric physicians appear to be less likely to monitor asymptomatic bacteriuria in any elderly patient population. Finally, we found that with regard to monitoring asymptomatic bacteriuria, both physician groups and the nurse group gave the greatest support for monitoring among elderly who have difficulty presenting symptoms of a UTI.