The Journal of the American Geriatrics Society published the results of a statewide program to improve the management of suspected urinary tract infections in long-term care. The reason the study was done was that too many residents were being treated for UTIs when in actuality they were experiencing “asymptomatic bacteriuria”. What does this mean? Well, maybe we need to go back to the basics of good infection control practices. Whether you utilize the McGeers criteria, some form of the Loeb checklist based worksheet for infections, or any other validated tool, we may tend to not use the resources consistently. I know from experience that “Lila always acts that way when she has a UTI”, call the physician, orders an antibiotic. Well once you start the antibiotic there is no reason to do a culture as the result may not be accurate. Then we think if we wait to treat there is a risk for sepsis. You are probably right in both of these scenarios so what do we do?

At a minimum, think twice before initiating an antibiotic and if one is ordered, obtain the culture prior to initiating the medication. If the culture comes back negative, get an order to stop the antibiotic, no use in continuing it if there is no infection!

Bottom line, at the end of the day, look for symptoms, confusion is common but could mean many other things aside from a UTI (i.e., delirium, dehydration, constipation, pain, etc.). Take a look at this study that was done and see if we can’t do a better job in your particular state. As always, share your success with us, HealthCap loves to share success stories!