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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 (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.

Some groups of people do still benefit from antibiotic treatment of UTIs. These individual include:
 
- 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, 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 of the Elder House Call Program, Johns Hopkins Bayview Medical Center and professor of medicine at Johns Hopkins Medicine.

Source: American Geriatrics Society

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