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Theme: Nephrology and Urology - Review

Urinary tract infection in older adults

    Theresa A Rowe

    Yale University School of Medicine, Department of Internal Medicine, Section of Infectious Diseases, PO Box 208022, New Haven, CT 06520-8022, USA

    &
    Manisha Juthani-Mehta

    * Author for correspondence

    Yale University School of Medicine, Department of Internal Medicine, Section of Infectious Diseases, PO Box 208022, New Haven, CT 06520-8022, USA.

    Published Online:https://doi.org/10.2217/ahe.13.38

    Urinary tract infection and asymptomatic bacteriuria are common in older adults. Unlike in younger adults, distinguishing symptomatic urinary tract infection from asymptomatic bacteriuria is problematic, as older adults, particularly those living in long-term care facilities, are less likely to present with localized genitourinary symptoms. Consensus guidelines have been published to assist clinicians with diagnosis and treatment of urinary tract infection; however, a single evidence-based approach to diagnosis of urinary tract infection does not exist. In the absence of a gold-standard definition of urinary tract infection that clinicians agree upon, overtreatment with antibiotics for suspected urinary tract infection remains a significant problem, and leads to a variety of negative consequences including the development of multidrug-resistant organisms. Future studies improving the diagnostic accuracy of urinary tract infections are needed. This review will cover the prevalence, diagnosis and diagnostic challenges, management, and prevention of urinary tract infection and asymptomatic bacteriuria in older adults.

    Papers of special note have been highlighted as: • of interest •• of considerable interest

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