041 UTIs and Urine Bacteria in Aging: How to get the right diagnosis and avoid unneeded antibiotics

In This Episode:

Dr. K explains why having bacteria in one’s urine does NOT mean one has a urinary tract infection (UTI) that requires antibiotics. In fact, as people get older, they may have bacteria in the urine but no UTI symptoms or other signs of infection. This condition, called “asymptomatic bacteriuria” is common, and is often inappropriately treated with antibiotics. In this episode:

• How to know if one has asymptomatic bacteriuria versus a UTI that warrants antibiotics
• Why having asymptomatic bacteriuria becomes more common as people become older
• Why the Infectious Disease Society of America and others have repeatedly urged doctors to NOT treat asymptomatic bacteriuria
• The challenge of correctly diagnosing UTIs in people with dementia
• How one can be harmed by using antibiotics to try to eliminate bacteria in the bladder
• What to do if you’re worried about urine bacteria — or  a possible UTI — in an older person

Related episode: 

014 Delirium & Hospital Confusion

Related Resources:

• Why Urine Bacteria Doesn't Mean a UTI Needs Antibiotics
• Choosing Wisely Recommendations of the Infectious Disease Society of America
• 26 Recommended Preventive Health Services for Older Adults
• Approach to a Positive Urine Culture in a Patient Without Urinary Symptoms
• Diagnosis and Management of Urinary Tract Infection in Older Adults
• Urinary Tract Infection Requiem for a Heavyweight