ArticleAge and ageing2022
Decisions on antibiotic prescribing for suspected urinary tract infections in frail older adults: a qualitative study in four European countries.
Article in Age and ageing, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 30 citations in OpenAlex.
- Tailored interventions to address determinants of practice.The Cochrane database of systematic reviews · 2026Pooled it
- Self-reported acceptability and feasibility of a multimodal intervention to reduce antibiotic prescriptions for urinary tract infections in primary care: a process evaluation of the RedAres trial among general practitioners and medical practice assistants.BMC health services research · 2025Trial
- Trial
- Trial
- 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
- Diagnosis of urinary tract infection in the emergency department - a real infection or an alarming indication for comprehensive geriatric assessment? A retrospective follow-up study.The Journal of frailty & aging · 2026Article
- Practice-level mechanisms contributing to successful implementation of a UTI antibiotic stewardship intervention: a qualitative study in Dutch general practices.BMC primary care · 2026Article
- Behavioural Determinants of Appropriate Antibiotic Prescribing for Urinary Tract Infections in Nursing Homes: A Qualitative Study of Stakeholders' Perspectives.Antibiotics (Basel, Switzerland) · 2025Article
- Factors influencing urinary tract infection prevention and antibiotic stewardship in European nursing homes: an interview study with staff.European geriatric medicine · 2025Article
- A shared approach to managing urinary tract infections in nursing homes improved perceived care quality, workload, and collaboration - a qualitative study.Scandinavian journal of primary health care · 2025Article
- Influence of a microbiological commentary on the management of asymptomatic bacteriuria.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2025Article
- Antimicrobial prescribing in French nursing homes and interventions for antimicrobial stewardship: a qualitative study.Antimicrobial resistance and infection control · 2024Article
- Article
- Diagnostic uncertainty and decision-making in home-based primary care: A qualitative study of antibiotic prescribing.Journal of the American Geriatrics Society · 2024Article
- Epidemiology and microbiology of recurrent UTI in women in the community in Oxfordshire, UK.JAC-antimicrobial resistance · 2024Article
- Feasibility of a placebo-controlled trial of antibiotics for possible urinary tract infection in care homes: a qualitative interview study.BJGP open · 2023Article
- Antibiotic prescription patterns in patients with suspected urinary tract infections in Ecuador.PloS one · 2023Article
Corrections and comments
- Commented on byGeriatrics.2023
Authors and funding
17 authors at 5 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgrounda suspected urinary tract infection (UTI) is the most common reason to prescribe antibiotics in a frail older patient. Frequently, antibiotics are prescribed unnecessarily. To increase appropriate antibiotic use for UTIs through antibiotic stewardship interventions, we need to thoroughly understand the factors that contribute to these prescribing decisions.
objectives(1) to obtain insight into factors contributing to antibiotic prescribing for suspected UTIs in frail older adults. (2) To develop an overarching model integrating these factors to guide the development of antibiotic stewardship interventions for UTIs in frail older adults.
methodswe conducted an exploratory qualitative study with 61 semi-structured interviews in older adult care settings in Poland, the Netherlands, Norway and Sweden. We interviewed physicians, nursing staff, patients and informal caregivers.
resultsparticipants described a chain of decisions by patients, caregivers and/or nursing staff preceding the ultimate decision to prescribe antibiotics by the physician. We identified five themes of influence: (1) the clinical situation and its complexity within the frail older patient, (2) diagnostic factors, such as asymptomatic bacteriuria, (3) knowledge (gaps) and attitude, (4) communication: interprofessional, and with patients and relatives and (5) context and organisation of care, including factors such as availability of antibiotics (over the counter), antibiotic stewardship efforts and factors concerning out-of-hours care.
conclusionsdecision-making on suspected UTIs in frail older adults is a complex, multifactorial process. Due to the diverse international setting and stakeholder variety, we were able to provide a comprehensive overview of factors to guide the development of antibiotic stewardship interventions.
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