Urinary tract infections in the elderly

Host, bacterial, and environmental factors all play a major role in the pathogenesis and management of urinary tract infection (UTI) in the elderly. Asymptomatic bacteriuria is prevalent but, in the absence of obstructive uropathy or infection stones, generally pursues a benign course and requires minimal or no treatment. Symptomatic bacteriuria requires prompt antimicrobial therapy and thorough evaluation for underlying structural abnormalities of the urinary tract. Despite improved treatment, mortality associated with UTI in the elderly remains high, particularly in hospitalized, institutionalized, and/or catheterized patients.