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RI Hospital: Nearly half of older women diagnosed with UTI not confirmed in urine culture
Date:4/22/2013

died the medical records of 153 older women who were diagnosed with a UTI during a visit to an emergency department. They found that only 57 percent of the 153 women who were given a diagnosis of a UTI actually had urine cultures that confirmed the diagnosis. Of the remaining patients whose urine studies did not confirm a UTI, 95 percent were administered or prescribed antibiotics in the ED. Inappropriate antibiotic use in the ED setting for presumed UTIs has been associated with antimicrobial resistance and undesired side-effects as antibiotics are the second leading class of drugs to cause adverse events, such as diarrhea due to Clostridium difficile (C-diff), in patients over age 65.

"Ultimately, we found that a large proportion of older women were overdiagnosed and overtreated for UTI," Mermel said. "Physicians assessing such patients cannot rely on non-specific symptoms such as confusion to confirm a diagnosis of UTI. More widespread use of straight catheterization in this patient population may reduce false-positive results of urine studies, thereby reducing unnecessary antibiotic exposure and may prompt clinicians to assess these patients for other etiologies to explain their symptoms."

Researchers said that further study must be conducted to determine if straight catheterization is truly the better method for obtaining urine for culture in this patient population, and to identify other strategies that will improve the accuracy of the diagnosis.


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Contact: Ellen Slingsby
eslingsby@lifespan.org
401-444-6421
Lifespan
Source:Eurekalert

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