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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com




Monday, March 3, 2014

Infección del tracto urinario

ALiEM - By Christina Shanvi, MD PhD | March 3rd, 2014
"It seems like a simple enough question: How do you diagnose and treat uncomplicated UTIs in older adults? The answer is: It depends. Part 1 of this post will discuss diagnosis of UTIs in this population, and part 2 will address treatment.
UTIs are the most common bacterial infection diagnosed in older adults (age 65 and over) and the most common reason for antibiotic use in this population. They account for 5% of ED visits by older adults. 
Bacteria in the urine occur on a spectrum from asymptomatic bacteriuria (ASB), uncomplicated UTI, to complicated UTI. It is important to distinguish between these three entities in order to guide therapy and prevent inappropriate antibiotic use."

  • UTIs and ASB are common in older adults, particularly those in long-term care facilities.
  • ASB does not require treatment.
  • To diagnose a UTI the patient should have pyuria, bacteriuria, and some symptoms. In cognitively intact older adults, symptoms are usually GU-related, such as dysuria, frequency, pelvic discomfort, incontinence, and change in the urine. In older adults with cognitive impairment, also consider non-specific symptoms such as altered mental status, functional decline, anorexia, and behavioral changes."