For older adults, antibiotics may not be appropriate treatment for some UTIs

In a new research paper published in the Journal of the American Geriatrics Society, Thomas E. Finucane, MD, of the Johns Hopkins Geriatrics Center at Johns Hopkins in Baltimore, suggests that prescribing antibiotics for urinary tract infections (or "UTIs") may often be avoided among older adults.

• "UTI" is a vague, overused diagnosis that may be applied to older adults who have no symptoms but may have bacteria in the urine and also may be experiencing confusion, falls, or other vague signs (including changes in the odor or color of urine). In most cases, antibiotics do not benefit these older people.

• Researchers are coming to a new understanding about the kinds of bacteria, viruses, and other microorganisms that live in the human body naturally. We now know that everyone's urine contains bacteria and viruses, for example. We also know that these microorganisms are usually helpful to overall well-being.

• In some cases, antibiotic treatment can be harmful, especially for older adults.

• People who are sick enough to require urgent antibiotic treatment regardless of findings in the urine.

• People with invasive bacterial diseases, especially kidney infections.

• Pregnant women and people about to have bladder or urinary tract surgery.

In his paper, Dr. Finucane says that microbiome studies--which examine the benefits and harms cause by the billions of organisms that naturally live in the human body--suggest that UTI treatment with antibiotics actually may be more harmful than we previously thought. If you think you have a UTI, or if you're currently using an antibiotic to treat a UTI, it's important to speak with a healthcare professional first before changing your care plan. Your doctor, nurse, or other provider can work with you to find a treatment plan that's best for you.

###

This summary is from "Urinary Tract Infection: Requiem for a Heavyweight." It appears online ahead of print in the March 2017 issue of the Journal of the American Geriatrics Society. The author is Thomas E. Finucane, MD, Co-director, Elder House Call Program, Johns Hopkins Bayview Medical Center and Professor of Medicine at Johns Hopkins Medicine.

This research summary was developed as a public education tool by the Health in Aging Foundation. The Foundation is a national non-profit established in 1999 by the American Geriatrics Society to bring the knowledge and expertise of geriatrics healthcare professionals to the public. We are committed to ensuring that people are empowered to advocate for high-quality care by providing them with trustworthy information and reliable resources. Last year, we reached nearly 1 million people with our resources through HealthinAging.org. We also help nurture current and future geriatrics leaders by supporting opportunities to attend educational events and increase exposure to principles of excellence on caring for older adults. For more information or to support the Foundation's work, visit http://www.HealthinAgingFoundation.org.

Included in more than 9,000 library collections around the world, the Journal of the American Geriatrics Society (JAGS) highlights emerging insights on principles of aging, approaches to older patients, geriatric syndromes, geriatric psychiatry, and geriatric diseases and disorders. First published in 1953, JAGS is now one of the oldest and most impactful publications on gerontology and geriatrics, according to ISI Journal Citation Reports®. Visit wileyonlinelibrary.com/journal/JGS for more details.

Founded in 1942, the American Geriatrics Society (AGS) is a nationwide, not-for-profit society of geriatrics healthcare professionals that has--for 75 years--worked to improve the health, independence, and quality of life of older people. Its nearly 6,000 members include geriatricians, geriatric nurses, social workers, family practitioners, physician assistants, pharmacists, and internists. The Society provides leadership to healthcare professionals, policymakers, and the public by implementing and advocating for programs in patient care, research, professional and public education, and public policy. For more information, visit AmericanGeriatrics.org.