Asymptomatic bacteriuria in older adults: when is it necessary to screen and treat?

The incidence of asymptomatic bacteriuria increases with age, and thus it is a common finding in older adults, especially the very old and the institutionalized. Bacteriuria in most older adults, while common, is often transient. The clinical significance is generally minor and the treatment yields very little benefit, is expensive, and may cause substantial drug toxicity. Guidelines to help determine which patients may benefit from treatment are included. Primary care providers for older adults in ambulatory, home, hospital, or institutional settings, should recognize asymptomatic bacteriuria and know when and when not to treat. This management decision will become an increasingly important aspect of gerontological health care.