HOME HELP CONTACT US SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Rapid Responses: Submit a response Alert me when this article is cited Alert me when Rapid Responses are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Grover, M. L. Articles by Weaver, A. L. Search for Related Content PubMed PubMed Citation Articles by Grover, M. L. Articles by Weaver, A. L. Social Bookmarking                      What's this?

Urinary Tract Infection in Women Over the Age of 65: Is Age Alone a Marker of Complication?

From the Department of Family Medicine, Mayo Clinic College of Medicine (MLG, JDB, FDE), Scottsdale, AZ
the Osher Institute, Harvard Medical School (AKK), Boston, MA
the Division of Biostatistics, Mayo Clinic College of Medicine (ALW), Rochester, MN

Correspondence: Corresponding author: Michael L. Grover, DO, Department of Family Medicine, Mayo Clinic College of Medicine, 13737 North 92nd Street, Scottsdale, AZ 85260 (E-mail: grover.michael{at}mayo.edu)

Background: We were interested to know if our older female patients with urinary tract infections (UTIs) might have differing pathogens or rates of Escherichia coli antibiotic sensitivity and if our physicians managed them in a manner similar or dissimilar to the care provided to younger patients with no complications.

Methods: This was a secondary analysis from patients excluded from a previous retrospective study regarding uncomplicated UTIs.

Results: Twenty-six percent of total patients with UTIs were older than 65 and otherwise medically uncomplicated whereas 21% were older patients who did have complicating factors. E. coli was a pathogen in 81% of uncomplicated elders’ and 54% of complicated elders’ cultures. E. coli sensitivity rate to sulfamethoxazole-trimethoprim (SMX/TMP) in both groups was 86%. Physicians were significantly less likely to prescribe SMX/TMP for complicated older patients with complications than for young patients with an uncomplicated UTI (P = .017); there was a significant trend of physicians to be less likely to prescribe SMX/TMP with advancing age in a patient and complications across all 3 groups (P = .011). Antibiotics rarely needed to be changed after cultures.

Conclusions: The presence of E. coli on culture in patients with a UTI changes based on medical complications, not age. Being medically complex did not result in reduced sensitivity of E. coli to SMX/TMP but was associated with increased rates of the presence of other pathogens. In our setting, treatment employed with SMX/TMP and without the use of culture and sensitivity may be effective for appropriately selected older women. Prospective studies are needed to determine the optimal approach to management.

CiteULike

Complore

Connotea

Del.icio.us

Digg

Reddit

Technorati

This article has been cited by other articles:

				C. D. J. den Heijer, G. A. Donker, J. Maes, and E. E. Stobberingh Antibiotic susceptibility of unselected uropathogenic Escherichia coli from female Dutch general practice patients: a comparison of two surveys with a 5 year interval J. Antimicrob. Chemother., August 3, 2010; (2010) dkq286v1. [Abstract] [Full Text] [PDF]

				M. A. Bowman and A. V. Neale In This Issue: Mini-Theme on Geriatric Care and Cancer Screening J Am Board Fam Med, May 1, 2009; 22(3): 231 - 233. [Full Text] [PDF]

				G. Warshaw Providing Quality Primary Care to Older Adults J Am Board Fam Med, May 1, 2009; 22(3): 239 - 241. [Full Text] [PDF]