The overdiagnosis of urinary infections in the elderly could indicate more serious health problems
A study led by IDIAPJGol researchers Carl Llor and Ana Moragas concludes that antibiotics are unnecessarily prescribed to treat suspected urinary infections in nursing homes
The overdiagnosis of urinary infections in elderly care facilities could be an indicator of more serious illnesses that may present similar, non-specific symptoms. This can delay the identification and treatment of more critical health issues. This situation also leads to inappropriate antibiotic prescriptions, which may contribute to increased resistance to these drugs and complicate the treatment of real infections in the future.
This non-systematic review, published in the journal Clinical Microbiology and Infection, is authored by IDIAPJGol researchers Carl Llor and Ana Moragas. The study points out that the overdiagnosis of urinary infections in nursing homes and the unnecessary prescription of antibiotics negatively affect patients' quality of life, delay accurate diagnoses, increase healthcare costs, and may cause adverse drug reactions.
According to the study's authors, this situation affects patients' quality of life, as antibiotic side effects, along with the psychological impact of having an infection diagnosis, can cause distress. Moreover, the unnecessary use of antibiotics and additional diagnostic tests that have not been proven effective in the elderly, such as urine test strips, can lead to increased healthcare costs.
Antibiotics can cause side effects and adverse reactions, especially in elderly people who have multiple conditions and are taking several medications. These reactions can lead to further health complications, hospitalization, or even increased mortality.
The Role of Nurses
This review highlights that nurses play a key role in the diagnostic process, as they are responsible for observing symptoms, conducting urine tests, and initiating antibiotic therapy. Their knowledge and training on managing urinary infections are crucial to improving patient outcomes.
The article emphasizes the need for clear and simple guidelines to assist nurses in making accurate diagnoses and reducing the unnecessary use of ineffective diagnostic tests and antibiotics. In this regard, the study suggests that if minimum criteria for diagnosing the infection are not met, alternative diagnoses should be considered.
IMAGINE
This non-systematic review was carried out by the IMAGINE study group, which focuses on standardizing infection prevention efforts, with special attention to urinary infections and the inappropriate use of antibiotics in elderly care homes across eight European countries. The project's goal is to influence clinical practice and infection prevention and control policies through hygiene practices and the promotion of rational antibiotic prescriptions in nursing homes to improve patient care and reduce the risk of antibiotic resistance.
Reference to the article
Llor C, Moragas A, Ruppe G, Lykkegaard J, Hansen MP, Antsupova VS, Jensen JN, Theut AM, Petek D, Sodja N, Kowalczyk A, Bjerrum L; IMAGINE study group. Diagnosing probable urinary tract infections in nursing home residents without indwelling catheters: a narrative review. Clin Microbiol Infect. 2024 Aug 30:S1198-743X(24)00419-1. doi: 10.1016/j.cmi.2024.08.020. Epub ahead of print. PMID: 39209268.
