GuidelineJournal of the American Medical Directors Association2018
The Development of a Decision Tool for the Empiric Treatment of Suspected Urinary Tract Infection in Frail Older Adults: A Delphi Consensus Procedure.
Guideline in Journal of the American Medical Directors Association, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
38 citing papers in PubMed, 79 citations in OpenAlex.
- Trial
- Syndromic Antibiograms and Nursing Home Clinicians' Antibiotic Choices for Urinary Tract Infections.JAMA network open · 2023Trial
- Effect of a multifaceted antibiotic stewardship intervention to improve antibiotic prescribing for suspected urinary tract infections in frail older adults (ImpresU): pragmatic cluster randomised controlled trial in four European countries.BMJ (Clinical research ed.) · 2023Trial
- Nurse Decision-making for Suspected Urinary Tract Infections in Nursing Homes: Potential Targets to Reduce Antibiotic Overuse.Journal of the American Medical Directors Association · 2021Trial
- An update on Escalating Drug Resistance among Uropathogenic Bacteria: Challenges in Treatment and Scope for Maneuver.Current microbiology · 2026Review
- Practice-level mechanisms contributing to successful implementation of a UTI antibiotic stewardship intervention: a qualitative study in Dutch general practices.BMC primary care · 2026Article
- Factors influencing urinary tract infection prevention and antibiotic stewardship in European nursing homes: an interview study with staff.European geriatric medicine · 2025Article
- Optimizing Prevention of Recurrent Urinary Tract Infections in Older Patients with Frailty.Drugs & aging · 2025Review
- The impact of a multifaceted intervention on antibiotic use for common infections in nursing homes in Spain. A before and after study.European geriatric medicine · 2025Article
- Appropriateness of antibiotic use in nursing homes for suspected urinary tract infections: comparison across five European countries.European geriatric medicine · 2025Article
- Article
- Temporal Trends ofAntibiotics (Basel, Switzerland) · 2025Article
- Understanding the Burden and Management of Urinary Tract Infections in Women.Diseases (Basel, Switzerland) · 2025Review
- Feasibility of Licensed Vocational Nurses Using a CDS App to Communicate Signs and Symptoms of a UTI.Nursing research and practice · 2025Article
- Article
- Improving Antibiotic Use in Nursing Homes by Infection Prevention and Control and Antibiotic Stewardship (IMAGINE): Protocol for a Before-and-After Intervention and Implementation Study.JMIR research protocols · 2024Article
- YELLOW RoUTIne prospective cohort study protocol: insight in the dynamics of bacteria in the elderly bladder.BMC infectious diseases · 2024Observational
- The Diagnosis, Treatment, and Prevention of Recurrent Urinary Tract Infection.Deutsches Arzteblatt international · 2024Review
- A tale of two bladders: Understanding common bladder issues in primary care.Canadian family physician Medecin de famille canadien · 2024Article
- The clinical usefulness of guideline-based strategies with and without the role of nonspecific symptoms to predict urinary tract infections in nursing homes: a decision curve analysis.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
18 authors at 14 institutions in 5 countries.
Funding
Abstract
objectivesNonspecific signs and symptoms combined with positive urinalysis results frequently trigger antibiotic therapy in frail older adults. However, there is limited evidence about which signs and symptoms indicate urinary tract infection (UTI) in this population. We aimed to find consensus among an international expert panel on which signs and symptoms, commonly attributed to UTI, should and should not lead to antibiotic prescribing in frail older adults, and to integrate these findings into a decision tool for the empiric treatment of suspected UTI in this population.
designA Delphi consensus procedure. SETTING AND
participantsAn international panel of practitioners recognized as experts in the field of UTI in frail older patients. MEASURES: In 4 questionnaire rounds, the panel (1) evaluated the likelihood that individual signs and symptoms are caused by UTI, (2) indicated whether they would prescribe antibiotics empirically for combinations of signs and symptoms, and (3) provided feedback on a draft decision tool.
resultsExperts agreed that the majority of nonspecific signs and symptoms should be evaluated for other causes instead of being attributed to UTI and that urinalysis should not influence treatment decisions unless both nitrite and leukocyte esterase are negative. These and other findings were incorporated into a decision tool for the empiric treatment for suspected UTI in frail older adults with and without an indwelling urinary catheter.
conclusionsA decision tool for suspected UTI in frail older adults was developed based on consensus among an international expert panel. Studies are needed to evaluate whether this decision tool is effective in reaching its aim: the improvement of diagnostic evaluation and treatment for suspected UTI in frail older adults.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.