Principles of antibiotic use for UTI and bacteriuria in residents of an aged-care facility

Urinary tract infection (UTI) is a common indication for the use of antibiotics in residents of an aged-care facility. Asymptomatic bacteriuria commonly occurs in residents of an aged-care facility; do not screen for or treat asymptomatic bacteriuria, except in patients undergoing elective urological procedures – see Asymptomatic bacteriuria in nonpregnant adults. Evidence shows that patients with asymptomatic bacteriuria treated with antibiotics have a higher rate of adverse effects without a reduction in the risk of developing a UTI and mortalityKrzyzaniak 2022. Furthermore, recurrent asymptomatic bacteriuria is not a UTI and does not require antibiotic therapy.

Overtreatment with antibiotics is common in residents of an aged-care facility and contributes to antimicrobial resistance. Stop antibiotic therapy if there is no benefit or if urine culture is not consistent with a UTIRowe 2014. For information on strategies for effective antimicrobial stewardship (AMS) in residential aged-care facilities, see Antimicrobial stewardship (AMS) in residential aged-care facilities.