Urinary tract infections: in the elderly, antibiotics should be prescribed promptly

Some urinary infections are self-curing, without antibiotics. But in older people, it's better not to take the risk.

Immediate prescription of antibiotics to elderly patients with urinary tract infections (or cystitis) is associated with a reduced risk of sepsis and death, compared to patients who receive antibiotics in the days following the diagnosis, or who do not not receive at all.
These are the latest results produced by Imperial College London, published in the BMJ. In concrete terms, this will help doctors make clinical decisions about when is the most appropriate time to prescribe antibiotics for the elderly.

Eight times more likely to develop a deadly infection

As part of this research, the team reviewed the records of 157,264 English over 65 years old with urinary tract infection. Some patients were prescribed antibiotics immediately (87% of cases studied), delayed their treatment by 7 days (6% of cases) or did not take any medication (7% of cases).

Of the patients who took antibiotics immediately, only 0.2% developed sepsis within 60 days. On the other hand, patients whose prescription of antibiotics had been delayed or who had not taken any antibiotic were up to eight times more likely to develop this fatal infection.

Risk of death

1.6% of patients who received antibiotics immediately died within 60 days. The risk of death during the same period in patients whose prescription of antibiotics had been delayed slightly increased (16%), while the risk had doubled in patients who had not taken any antibiotic.

"Over-consumption of antibiotics must be avoided because urinary tract infections can sometimes improve without medication, but our research suggests that antibiotics should not be delayed in elderly patients," the study director concluded. Cystitis is a urinary infection localized in the bladder. Most often, it is caused by the bacterium Escherichia Coli.

Video: Symptoms of a UTI (February 2020).