Assessment and management of urinary tract infections in aged care facilities

To compare assessment and management of urinary tract infections (UTI) for residents in aged care facilities (ACF) with evidence-based infection criteria and recommended therapy.

A retrospective clinical audit was conducted for all short-course antibiotics (SCA) prescribed to treat presumed UTIs (p-UTIs). Surveillance, microbiological and dispensing data determined whether p-UTIs met the revised McGeer criteria for infection and the extent to which SCAs complied with guideline recommendations.

Ten out of 74 (14%) p-UTIs were confirmed infections, that is met both the clinical and microbiological criteria for infection. Thirty-four out of 74 (46%) p-UTIs were classified as asymptomatic bacteriuria. The dose and frequency of the prescribed SCA were concordant with guideline recommendations for 87% and 85% of the courses, respectively; however, only 42% of the SCAs followed the recommended duration of therapy.

Overdiagnosis of UTIs and consequent overprescribing of antibiotics, specifically extended duration, are consistent with similar studies.