Half of the antibiotic prescriptions used to treat urinary tract infections in nursing homes are unnecessary. This is shown by a study published in the journal European Geriatric Medicine, in which IDIAPJGol participated. The study, part of the European IMAGINE project coordinated by IDIAPJGol, recommends standardizing protocols and improving the training of professionals working in nursing homes to enhance antibiotic use and reduce antimicrobial resistance.
The research was carried out between February and April 2024 and included more than 9,700 residents from 109 nursing homes in eight European countries: Denmark, Greece, Hungary, Lithuania, Poland, Slovakia, Slovenia and Spain.
Non-specific symptoms
During the study period, 975 antibiotic treatments were initiated for suspected urinary tract infections in residents without permanent urinary catheters. The average age of residents receiving treatment was 86 years, and 76% were women.
The study shows that there is no clear pattern shared across countries. While some placed emphasis on general symptoms such as confusion or behavioral changes, others gave more importance to urinary symptoms or changes in urine.
The differences in symptoms and signs attributed to urinary tract infections across countries highlight the complexity of diagnosis and the lack of consensus in nursing homes regarding this type of infection.
Overdiagnosis
The study emphasizes that this diagnostic uncertainty may lead to overdiagnosis and inappropriate antibiotic prescribing, with important consequences such as adverse effects in residents and an increased risk of antimicrobial resistance—one of the major global health threats, according to the World Health Organization.
The research team concludes that clearer, standardized guidelines are needed for healthcare professionals working in nursing homes, as well as further research on how to accurately diagnose urinary tract infections and more staff training.
Article reference
Theut M, Jensen JN, Antsupova V, Hansen MP, Vallejo-Torres L, Llor C, Garcia-Sangenis A, Monfà R, Sodja N, Bálint A, Jaruseviciene L, Lionis C, Kowalczyk A, Glasova H, Lykkegaard J; IMAGINE study group. Signs and symptoms attributed to urinary tract infections in nursing home residents across eight European countries. Eur Geriatr Med. 2026 Feb 13. doi: 10.1007/s41999-026-01427-9. Epub ahead of print. PMID: 41688624.
