Consistent guidelines for treating urinary tract infections

Consistent guidelines for treating urinary tract infections

New bacteria-killing light-activated coating "We don't know what comes first; is the urinary tract infection causing confusion and the dulling of cognition or is it the confusion that is causing the UTI," Clifford explained. "That's never been addressed and never been found, it's just an association made from seeing more confusion in some older adults and then they happen to have a urinary tract infection." In addition to the largely unstudied and unproven confusion-UTI link, Clifford said the tendency to check for a UTI has increased because testing generally requires urine analysis, a process that is not particularly difficult or expensive. If the urine analysis reveals the presence of bacteria, the inclination is to diagnose a UTI and begin antibiotic treatment without knowing for certain if the pathogen is causing a problem. "When we overtest, there is a likelihood to also overtreat," Clifford added. "We might see there's new confusion, so let's just get a urine analysis and see if something's growing, and if there is an infection, even if we may not be sure what it is, it might cause us to go ahead and try this antibiotic anyway." Cognition difficulties and dementia may have rendered some PALTC residents unable to communicate verbally. Others may have a history of UTI-related pathology or may be otherwise perceived as vulnerable or immune compromised. In some circumstances, Clifford said, residents presenting these conditions may prompt a clinician to test for a UTI and then prescribe antibiotic treatment without having a complete picture of the infection. However, he cautions, simply identifying bacteria in urine in a person experiencing one or more of these factors doesn't always mean an antibiotic is required. In creating its consensus statement, Clifford said the committee's primary objective was to encourage clinicians to go beyond reflexively ordering a urine analysis and antibiotics. Rather than focusing solely on symptoms like confusion and urine samples, the committee advises looking for additional factors. For instance, is the person using the restroom more often? If they have been diagnosed with dementia, is the dementia getting worse? Do you have to change their undergarments more often? "Let's try to make sure the indication for starting antibiotics is truly there and that they're truly needed," Clifford emphasized. "First, let's look for a couple other symptoms before going straight to that. That's what we're going for with this document. We're trying to effectively explain what's been found over the last few years. The goal is to try to protect the antibiotics that we have and try to use everything appropriately." Now that the statement has been published, Clifford said the committee is in the process of getting the recommendations into the hands health care providers, especially those in PALTC settings. As is the case with most other medical literature, it takes time to get the information disseminated. To aid the process, AMDA is developing a mini-brochure that practitioners can carry in their lab coat pocket or work bag so they can more quickly and easily reference the statement's main recommendations. "This can't just be a one-off thing; you really do have to look for other changes, you do have to look for other symptoms. That's really what we're going on with this statement," Clifford stressed. "It's not thinking, 'Hey, they're confused and they weren't yesterday; so check for a UTI.' It's about trying to encourage everybody to take a minute and think about it before throwing on an antibiotic. It's really about stressing the need to know your patient as much as you can." Source: Texas Tech University Health Sciences Center Journal reference: Ashraf, M. S. et al . (2020) Diagnosis, Treatment, and Prevention of Urinary Tract Infections in Post-Acute and Long-Term Care Settings: A Consensus Statement From AMDA's Infection Advisory Subcommittee. Journal of American Medical Directors Association. doi.



Also in Industry News

How to decide whether or not to start treatment for prostate cancer?
How to decide whether or not to start treatment for prostate cancer?

0 Comments

How to decide whether or not to start treatment for prostate cancer?

Read More

Analysis of the SARS-CoV-2 proteome via visual tools
Analysis of the SARS-CoV-2 proteome via visual tools

0 Comments

Analysis of the SARS-CoV-2 proteome via visual tools

Read More

$65m investment increases British Patient Capital’s exposure to life sciences and health technology
$65m investment increases British Patient Capital’s exposure to life sciences and health technology

0 Comments

$65m investment increases British Patient Capital’s exposure to life sciences and health technology

Read More