ArticleArchives of gerontology and geriatrics2017
Treatment of asymptomatic UTI in older delirious medical in-patients: A prospective cohort study.
Article in Archives of gerontology and geriatrics, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 41 citations in OpenAlex.
- Associations of delirium with urinary tract infections and asymptomatic bacteriuria in adults aged 65 and older: A systematic review and meta-analysis.Journal of the American Geriatrics Society · 2021Pooled it
- Antibiotics for Delirium in Older Adults With No Clear Urinary Tract Infection: A Multicentre, Pragmatic, Randomized Trial-Vanguard Results.Journal of the American Geriatrics Society · 2026Trial
- A Novel and Reproducible Urinary Diagnostic Framework Reduces Health Care and Antibiotic Utilization for Urinary Tract Infections.Open forum infectious diseases · 2025Article
- Delirium Prevention and Management in Older Adults in the Emergency Department.Emergency medicine clinics of North America · 2025Review
- When urine testing to rule out infection does more harm than good.Canadian family physician Medecin de famille canadien · 2024Article
- Asymptomatic Urinary Tract Infection Treatment in Adults Admitted to Inpatient Psychiatry: A Retrospective COHORT study.Hospital pharmacy · 2024Article
- Diagnosis of urinary tract infections in the hospitalized older adult population in Alberta.PloS one · 2024Article
- Associations between early in-hospital medications and the development of delirium in patients with stroke.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2023Article
- Reducing unnecessary urine culture testing in residents of long term care facilities.BMJ (Clinical research ed.) · 2023Article
- Potentially inappropriate prescriptions of antibiotics in geriatric psychiatry-a retrospective cohort study.Frontiers in psychiatry · 2023Article
- Effect of inpatient antibiotic treatment among older adults with delirium found with a positive urinalysis: a health record review.BMC geriatrics · 2022Article
- Urinary Tract Infection Investigation and Treatment in Older Adults Presenting to the Emergency Department with Confusion: a Health Record Review of Local Practice Patterns.Canadian geriatrics journal : CGJ · 2021Article
- Prospective cohort study on hospitalised patients with suspected urinary tract infection and risk factors por multidrug resistance.Scientific reports · 2021Observational
- So-called Urinary Tract Infection in the Era of COVID-19.Journal of the American Geriatrics Society · 2020Article
- Elevated urine IL-10 concentrations associate withImmunity & ageing : I & A · 2019Article
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDespite clinical practice guidelines, asymptomatic bacteriuria (ASB) in older people is frequently treated. A common reason for treating ASB is a change in mental status.
objectiveTo determine how often asymptomatic UTI is treated in older medically ill delirious individuals and its association with functional recovery.
methodsConsecutive older medical in-patients were screened for delirium, and followed in hospital. Treatment for asymptomatic UTI was defined as documented treatment for a possible urinary tract infection with antibiotics, without concurrent infectious or urinary symptoms. The primary outcome was functional recovery at discharge or 3 months post-discharge. Poor functional recovery was defined by any one of death, new permanent long-term institutionalization or decreased ability to perform activities of daily living.
resultsThe study sample comprised 343 delirious in-patients, of which 237 (69%) had poor functional recovery. Ninety two (27%) delirious in-patients were treated for asymptomatic UTI. Treatment for asymptomatic UTI was associated with poor functional recovery compared to other delirious in-patients (RR 1.30, 95% CI: 1.14-1.48 overall). Similar results were seen when the analysis was restricted to only bacteriuric delirious individuals. Seven (7.5%) individuals treated for asymptomatic UTI developed Clostridium difficile infection compared to eight (3.2%) in the remainder of the delirious cohort (OR 2.45, 95% CI: 0.86-6.96).
conclusionsThese results suggest that treatment of asymptomatic UTI in older medical in-patients with delirium is common, and of questionable benefit. Further research is needed to establish guidelines to minimize over-treatment of UTI in older delirious in-patients.
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