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Urinary Tract Infections

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A urinary tract infection (UTI), is an infection of the kidneys, bladder or urethra. UTI's are one of the most common reasons for antibiotic prescribing in primary and secondary care, with urine samples accountable for the most significant proportion of samples processed by microbiology labs.

Within the elderly population, diagnostic assessment can be troublesome as they often have asymptomatic bacteriuria, which becomes more prevalent as they age. Due to higher levels of bacteriuria, urine cultures become an unreliable diagnostic test in this population. Elderly patients tend to be prescribed (inappropriately) antibiotics for an asymptomatic UTI even though the evidence suggests that this can cause adverse effects with no benefit to the patient.

  • Adverse effects of inappropriate antibiotic prescribing include:
  • Clostridium difficile infection (CDI)
  • Methicillin-resistant Staphylococcus aureus (MRSA) infection
  • Development of antibiotic-resistant UTIs 

In response to the UK action plan for reducing antimicrobial resistance clinical guidelines have been developed by the Scottish Intercollegiate Guidelines Network (SIGN) and adopted by the National Institute for Health and Care Excellence (NICE) to facilitate the diagnosis and management of UTI's.

SIGN Guideline 88; Management of suspected bacterial urinary tract infection in adults

NICE Quality Standard 90; Urinary tract infections in adults

The main points are included in the following flow diagrams: If you have any feedback or comments regarding this post please let us know.

Men

Women

Pregnant

Older Adult



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