Assessment and management of urinary tract infections in aged care facilities

Abstract

To compare assessment and management of urinary tract infections (UTI) for residents in aged care facilities (ACF) with evidence-based infection criteria and recommended therapy. A retrospective clinical audit was conducted for all short-course antibiotics (SCA) prescribed to treat presumed UTIs (p-UTIs). Surveillance, microbiological and dispensing data determined whether p-UTIs met the revised McGeer criteria for infection and the extent to which SCAs complied with guideline recommendations. Ten out of 74 (14%) p-UTIs were confirmed infections, that is met both the clinical and microbiological criteria for infection. Thirty-four out of 74 (46%) p-UTIs were classified as asymptomatic bacteriuria. The dose and frequency of the prescribed SCA were concordant with guideline recommendations for 87% and 85% of the courses, respectively; however, only 42% of the SCAs followed the recommended duration of therapy. Overdiagnosis of UTIs and consequent overprescribing of antibiotics, specifically extended duration, are consistent with similar studies.