Antibiotic management of urinary tract infections in elderly patients ( 65 years and more) in primary care and its association with bloodstream infections and all cause mortaliy: population based cohort study
This is a big data study including 157,264 patients with 312,896 urinary tract infections episodes. Of these patients, 7.2 % did not have antibiotics being prescribed and 6.2 % a delay in antibiotic prescribing. 1,539 bloodstream infections deriving from UTI were registered (0.5 %) within 60 days after urinary track infection diagnosis. The rate of bloodstream infections were more common among patients who did not have prescription of antibiotics (2.9 %, 647) and patients with delayed prescription (2.2 %). Hospital admission rate was double for patients who antibiotics were not prescribed or delayed prescription (27 %) compared with patients with initial rapid prescription (14 %). Mortality was significantly higher in patients who did not have initially prescribed antibiotics or delayed antibiotics prescription. Men aged 85 years were particularly at risk for bloodstream infection and 60 day mortality.
Editor’s note: Urinary tract infection should not be confused with asymptomatic bacteriuria: this latter condition does not need antibiotic therapy and, as named, is asymptomatic.
Gharbi M, Drysdale JH, Lishman H, Goudie R, Molokhia M, Johnson AP, et al.Antibiotic management of urinary tract infections in elderly patients (65 years and more) in primary care and its association with bloodstream infections and all cause mortaliy: population based cohort study. BMJ. 2019;364:1525. https://doi.org/10.1136/bmj.1525.