Abstract
The elderly population is now increasing in the world. A higher incidence of bacteriuria and urinary tract infection (UTI) is observed in elderly patients, in both long-term care facilities and at home. The management of elderly patients with UTI is increasing in clinical significance. Almost all of UTI in the elderly is complicated UTI. Control of the underlying diseases in the urinary tract is quite important in the management of UTIs in elderly patients. For pyelonephritis, switch therapy using aminoglycosides and fluoroquinolones, carbapenems, third-generation cephalosporines, or penicillins are selections of choice. The recommended duration of treatment for patients with pyelonephritis is 14 days. Seven to 10 days of treatment using fluoroquinolones or trimethoprim-sulfamethoxazole is recommended for the treatment of elderly patients with symptomatic cystitis. Although asymptomatic bacteriuria is quite common in the elderly population, antibiotic treatment has no benefit for such patients. Intravaginal estrogen replacement is one of choice for the prevention of recurrent UTIs in postmenopausal women.
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References and Recommended Reading
Crossley KB, Peterson PK: Infections in the elderly. Clin Infect Dis 1996, 22:209–215.
Raz R: Urinary tract infection in elderly women. Int J Antimicrob Agents 1998, 10: 177–179.
Bjornsdottir CT, Geirsson RT, Jonsson PV: Urinary incontinence and urinary tract infections in octogenarian women. Acta Obstet Gynecol Scand 1998, 77:105–109.
Stalam M, Kaye D: Antibiotic agents in the elderly. Infect Dis Clin North Am 2000, 14:357–369.
Beier MT: Management of urinary tract infections in nursing home elderly: a proposed algorithmic approach. Int J Antimicrob Agents 1999, 11: 275–284. The author described algorithmic approach to nursing home residents concerning to management of UTIs.
Raz R, Gennesin Y, Wasser J, et al.: Recurrent urinary tract infections in postmenopausal women. Clin Infect Dis 2000, 30:152–156. authors revealed three urologic risk factors; incontinence, presence of cystocele, postvoiding residual urine, of recurrent UTIs in the postmenopausal women. This suggests important point to manage or treat such patients with recurrent UTIs
Bendall MJ: Urinary tract infection. In Cattell WR, ed. Infections of the Kidney and Urinary Tract. Oxford: Oxford Medical Publication; 1996:234–246.
Matsumoto T, Kumazawa J: Urinary tract infection in geriatric patients. Int Antimicrob Agents 1999, 11: 269–273.
Farley MM, Harvey RC, Stull T, et al.: A population based assessment of invasive disease due to group B streptococcus in nonpregnant adults. N Engl J Med 1993, 328:1807–1811.
Trivalle C, Martin E, Martel P, et al.: Group B streptococcal bacteremia in the elderly. J Med Microbiol 1998, 47:649–652.
Agirre M, Collins MD: Phylogenetic analysis of some Aerococcus-like organisms from urinary tract infections: description of Aerococcus urinae sp. J Gen Microbiol 1992, 138:401–405.
Schuur PMH, Kasteren MEE, Sabbe L, et al.: Urinary tract infections with Aerococcus urinae in the south of the Netherlands. Eur J Clin Microbiol Infect Dis 1997, 16:871–875.
Nicolle LE: Urinary tract infections in long term care facilities. Infect Control Hosp Epidemiol 1993, 14:220–225.
Nicolle LE, Strausbaugh LJ, Garibaldi RA: Infections and antibiotic resistance in nursing homes. Clin Microbiol Rev 1996, 9:1–17.
Warren JW, Palumbo FB, Fitterman L et al.: Incidence and characteristics prescribing in the long-term care facility. J Am Geriatr Soc 1991, 39:963–972.
Nicolle LE: Urinary infections in the elderly: symptomatic or asymptomatic? Int J Antimicrob Agents 1999, 11: 265–268.
Nicolle LE, Marghew JW, Bryan L: Prospective, randomized comparison of therapy and no therapy for asymptomatic bacteriuria in institutionalized women. Am J Med 1987, 83:2–33.
Abrutyn E, Boscia SA, Berline JA, et al.: Does asymptomatic treatment reduce mortality and does antimicrobial treatment reduce mortality in elderly ambulatory women? Ann Intern Med 1994, 120:827–833.
Nicolle LE, Duckworth H, Brunka J, et al.: Urinary antibody level and survival in bacteriuric institutionalized older subjects. J Am Geriatr Soc 1998, 46:947–953.
Bergeron M: Treatment of pyelonephritis in adults. Med Clin North Am 1995, 79:619–649.
Warren JW, Abrutyn E, Hebel JR, et al.: Guidelines for antimicrobial treatment of uncomplicated acute bacterial cystitis and pyelonephritis in women. Clin Infect Dis 1999, 29:745–758.
Stamm WE, Hooton TM: Management of urinary tract infections in adults. N Engl J Med 1993, 329:1328–1334.
Stamm WE, Norrby SR: Urinary tract infection: Disease panorama and challenge. J Infect Dis 2001, 103(suppl):1–4. Important review describing the future studies, which clarify unresolved problems in the field of UTIs.
Brandberg A, Mellstrom D, Samsioe G: Low dose estriol treatment in elderly women with urogenital infections. Acta Obstet Gynecol Scand Suppl 1987, 140:33–38.
Kirkengen AL, Andersen P, Gjersoe E, et al.: Oestriol in the prophylactic treatment of recurrent urinary tract infections in postmenopausal women. Scand J Prime Health Care 1992, 10:139–142.
Raz P, Stamm W: A controlled trial of intravaginal estriol in menopausal women with recurrent urinary tract infections. N Engl J Med 1993, 329:753–756.
Cardozo L, Benness C, Abbott D: Low dose oestrogen prophylaxis for recurrent urinary tract infections in elderly women. Br J Obstet Gynecol 1998, 105:403–407.
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Matsumoto, T. Urinary tract infections in the elderly. Curr Urol Rep 2, 330–333 (2001). https://doi.org/10.1007/s11934-001-0073-1
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DOI: https://doi.org/10.1007/s11934-001-0073-1