Don’t treat a bacteriuria with antibiotics in elderly patients without urinary symptoms.

Don’t treat a bacteriuria with antibiotics in elderly patients without urinary symptoms.

Type of practice

Drugs

Age

Geriatric

Topic Area

Hospital Internal Medicine

An asymptomatic bacteriuria should be managed conservatively. In elderly people, a bacteriuria is not necessarily harmful, while antibiotics are not obviously beneficial: often, they bring about undesirable effects, such as specific adverse reactions and undue selective pression over the colonizing bacteria (mainy enteric), wiih the development of resistant species. Screening and subsequent treatment of asymptomatic bacteriuria is justified only before urological procedures with anticipated mucosal bleeding. In 30% of asymptomatic subjects, a bacteriuria is not confirmed by a second examination.

Sources

1. Infectious Disease Society of America Guidelines for the diagnosis and teatment of asymptomatic bacteriuria in adults. Clin Infect Dis 2005; 40: 643-665.
2. Société de Pathologie Infectieuse de Langue Française (SPILF) et Association française d'urologie (AFU). Infections urinaire nosocomiales de l'adulte. Médecine et Maladies Infectieuses 2003; 33: 193s-215s.
3. Bulfoni A, Concia E, Costantino S, Giusti M, Iori I, Mazzei T, Nardi R, Salsi A, Schito G. Orientamenti terapeutici per il trattamento delle infezioni batteriche nel paziente anziano in Medicina Interna. Italian J Med 2007; (1)2 Suppl: III-IV, 156s-61s.

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