The current demography of Western countries shows that the population of older adults will increase steadily in the near future. The budget and human resources devoted to the proper care of this important population will increase in a parallel fashion. Since UTI is a major infectious problem in older adults, it is important that clinicians understand the particular challenges associated with its diagnosis and treatment in order to provide the best care possible. As we have seen, the clinical diagnosis of symptomatic UTI can be difficult in a population with a high prevalence of asymptomatic bacteriuria, for which treatment is not warranted and can even be harmful. Communication difficulties in patients with functional impairment can also make the diagnosis difficult, hindering the clinician's ability to determine the presence of new signs or symptoms. Another major issue is the continuing emergence of resistant bacterial strains; it is a pressing issue in the institutionalized population, where increased antimicrobial use contributes to the selection of resistant clones. It is then ever more important for the clinician to use antimicrobials judiciously among older adults. New compounds are available to treat UTI in the older adult; the clinician is invited to complete this short summary by looking at the product monographs and choosing the appropriate antibiotic in the context of possible side effects, drug interactions, site of infection, and microbiology results including drug susceptibility. Rational use of antimicrobials in the treatment of UTI in the older adult is called for in order to both provide appropriate care and control the spread of resistant organisms in this population.
Geriatrics and Aging. 2008;11(10):582-588. © 2008 1453987 Ontario, Ltd.
Cite this: Urinary Tract Infections in Older Adults: Current Issues and New Therapeutic Options - Medscape - Nov 01, 2008.