How Are Utis Treated In Older Adults
UTIs can be treated the same for all ages with antibiotics. However, depending on the persons age, health, and severity of the infection, it may take several weeks and a longer course of antibiotics. In more severe cases, seniors may need to be hospitalized to receive IV antibiotics. Look for the signs for early detection in treating a UTI in the elderly so that it doesnt get more severe.
Of course, the best way to treat a UTI is to prevent them. Here are some tips to prevent UTIs, which include the obvious, drinking more water, wiping front to back, and peeing after sex. Yes, older adults have sex too. Those prone to recurrent UTIs, may want to consult with their doctor on taking supplements to keep them at bay. Evidence shows that D-mannose and cranberry powder help prevent bacteria from sticking to your vaginal parts. Checkable Urinary Tract Balance provides all of the nutrients needed to keep UTIs away.
Causes Of Urinary Tract Infections
Urinary tract infections are usually caused by bacteria from poo entering the urinary tract.
The bacteria enter through the tube that carries pee out of the body .
Women have a shorter urethra than men. This means bacteria are more likely to reach the bladder or kidneys and cause an infection.
Things that increase the risk of bacteria getting into the bladder include:
- having sex
do not use scented soap
do not hold your pee in if you feel the urge to go
do not rush when going for a pee try to fully empty your bladder
do not wear tight, synthetic underwear, such as nylon
do not drink lots of alcoholic drinks, as they may irritate your bladder
do not have lots of sugary food or drinks, as they may encourage bacteria to grow
do not use condoms or a diaphragm or cap with spermicidal lube on them try non-spermicidal lube or a different type of contraception
Antibiotics Can Cause Serious Problems
Antibiotics can cause side effects, especially in older adults. Side effects include fever, rash, nausea, vomiting, diarrhea, ruptured tendons, nerve damage, and kidney failure.
Using antibiotics can lead to vaginal yeast infections and other infections, including one that can cause severe diarrhea, a hospital stay, and even death in older people.
Also, older adults often take other medicines that can interact dangerously with antibiotics.
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Private Duty Nursing Services
Sometimes, seniors need help with more than daily living tasks and require a licensed medical professional. Centric Healthcare offers the services of private duty nurses who attend to your or your loved ones medical needs in your home. Examples of our services that can assist in the treatment and prevention of UTI include assistance with catheter care, medication administration, and a trained eye that can help identify self-care needs and watch for classic and non-classic UTI symptoms.
Can Utis Be Prevented
These tips can help prevent UTIs:
- In infants and toddlers, change diapers often to help prevent the spread of bacteria that cause UTIs. When kids are potty trained, itâs important to teach them good hygiene. Girls should know to wipe from front to rear not rear to front to prevent germs from spreading from the anus to the urethra.
- School-age girls should avoid bubble baths and strong soaps that might cause irritation. They also should wear cotton underwear instead of nylon because itâs less likely to encourage bacterial growth.
- All kids should be taught not to âhold itâ when they have to go. Pee that stays in the bladder gives bacteria a good place to grow.
- Kids should drink plenty of fluids but avoid those with caffeine.
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What Is The Outlook
Most people improve within a few days of starting treatment. See a doctor if you do not quickly improve. If your symptoms do not improve despite taking an antibiotic medicine then you may need an alternative antibiotic. This is because some bacteria are resistant to some types of antibiotics. This can be identified from tests done on your urine sample.
Utis And Hospital Stays
A hospital stay can put you at risk for a UTI, particularly if you need to use a catheter. This is a thin tube that’s inserted through the urethra to carry urine out of the body. Bacteria can enter through the catheter and reach the bladder. This is more often a problem for older adults who require prolonged hospital stays or who live in long-term care facilities.
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Complicated Urinary Tract Infection
Urinary tract infection in patients with renal calculi, those with pyelonephritis, prostatitis, orchitis, patients with long-standing indwelling catheters or those using intermittent self-catherisation are likely to be complicated. These patients are likely to have an infection that involves other parts of the renal tract apart from the urinary bladder. They often need hospitalisation and surgical intervention like nephrostomy tubes or ureteric stents.
Intravenous antibiotics are usually prescribed for this group of patients. Treatment can be modified based on known multi-drug resistant organism colonisation or previous urine culture result. Usually, patients with complicated UTI require a 10â14 day course of antibiotic treatment.
The Evidence: Diagnosis Management And Prevention
We searched Ovid for English-language human studies conducted among adults aged 65 years and older and published in peer-reviewed journals from 1946 to November 20, 2013. We focused on community-dwelling older adults. Search terms included UTI, asymptomatic bacteriuria, risk factors and UTI, community-onset UTI, functional decline and UTI, delirium and UTI, dehydration and UTI, diagnosis and UTI, diet and drug therapy and UTI, prevention and UTI, and urine tests and UTI. We also searched for recently published Cochrane reviews regarding treatment and prevention of UTI in community-dwelling older adults. The recommendations that follow are based on evaluation of the existing evidence.
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Why Does Your Risk For Utis Increase With Age
Again, there are a few reasons that the elderly are more susceptible to UTIs. In both men and women over 65 the risk becomes greater because they tend to have more difficulties fully emptying their bladder. This causes bacteria to develop in the urinary system and turn into a UTI. In older men, this often happens because of a common condition called benign prostatic hyperplasia , or an enlarged prostate gland. The enlarged prostate blocks the flow of urine and prevents the bladder from fully emptying. As women age, the bladder muscles weaken and prevent the bladder from emptying completely.
Post-menopausal women also produce lower amounts of estrogen that creates an imbalance of good and bad bacteria in the vagina and cause a UTI. As estrogen production falls in, UTIs can occur more frequently.
Other risk factors to consider for UTIs in older adults include:
- Having a suppressed immune system
- Exposure to different bacteria in the hospital or care facility
- Poor hygiene by elderly adults or their caregivers
How To Prevent Urinary Tract Infections In The Elderly
With a proper understanding of UTI, its potential causes, and risk factors there are some simple things that all of us can do to help prevent infections in our urinary tracts. Some of the most practical preventive behaviors are:
Drink plenty of fluids daily, especially water
Urinate as soon as the urge hits
Urinate immediately after sexual intercourse
Wipe from front to back after a bowel movement
Avoid bladder irritants like caffeine and alcohol
Avoid irritating feminine hygiene products like deodorants, douches, and powders
Drink cranberry juice
In addition to the suggestions listed above, here are some preventive behaviors specifically for avoiding UTI in seniors:
Establish and follow a regular urination schedule, using alarms if necessary
Take enough time to empty the bladder completely when urinating
Wear cotton underwear and loose-fitting pants
Change incontinence pads and underwear immediately after they are soiled
The prevention of UTI in older adults boils down to two words: better care. Remember, as people age, they sometimes lose the ability to care for themselves in ways that we all take for granted when we are younger. This makes it essential for loved ones and professional caregivers to be vigilant, look for unmet care needs, and respectfully provide that care when necessary.
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Role Of Urinary Testing In Diagnosing Symptomatic Utis In Older Adults
The utility of urinary dipstick testing, urinalysis, and urine culture is challenging in the older adult because of the high prevalence of bacteriuria and pyuria that may not be clinically important. As in the case of Mrs M, all urinary studies to evaluate for leukocyte esterase, nitrites, pyuria, and bacteriuria over a 2-year period were positive.
The urinary dipstick, although easy and convenient, has variable test characteristics.38 Sensitivity and specificity for urinary dipstick testing to evaluate for leukocyte esterase, nitrites, or both vary in older adults by the age of study participants, clinical suspicion of UTI, and laboratory definition for UTI used . The sensitivity and specificity for a positive dipstick test in older patients with was 82% and 71% , respectively.27 Other studies of elderly patients showed the negative predictive value for dipstick testing ranges from 92% to 100%.4,28 Urinary dipstick analysis should be performed in the out-patient setting primarily to rule out and not to establish a diagnosis of UTI. In a patient with a low pretest probability of UTI, if the dipstick is negative for leukocyte esterase and nitrites, it excludes the presence of infection and mitigates the need to obtain urinalysis and urine culture . High false-positive rates limit dipstick testing effectiveness.27 Further urinary studies are warranted for patients with a high pretest probability of UTI.
Symptoms Of Urinary Tract Infection In Pregnant Woman
Pregnant women are more susceptible to UTIs for a number of reasons. The first is that the pregnancy itself causes changes in the urinary tract. The expanding uterus puts pressure on the bladder, which can lead to urine pooling and an increased risk of infection. In addition, pregnancy hormones can make it easier for bacteria to attach to the urinary tract.
The most common symptom of a UTI in a pregnant woman is a burning sensation when urinating. Other symptoms may include:
- cloudy or bloody urine
- fever or chills
A UTI can cause serious health complications for both you and your baby if it is not treated promptly.
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Symptoms Of Urinary Tract Infection In Elderly Woman
Symptoms of cystitis can be difficult to detect, and patients may not actively give this information to you- this is why your communication and consultation skills .
Patients present with symptoms that are not classic for a UTI, such as
chronic dysuria urinary incontinence general sense of feeling unwell issues with gait or falls change in mental status so be careful!
When Do Utis Need To Be Treated In Seniors
Guidelines say that if an elderly person has bacteria in their urine and they have at least two symptoms of UTI, they should be treated. Some people assume that an older person who becomes confused probably has a UTI. UTI can cause delirium in the elderly, but dehydration is a more common cause. These are the symptoms to watch out for at any age:
- Fever or chills
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How Common Are Urine Infections
Urine infections are much more common in women. This is because in women the urethra – the tube from the bladder that passes out urine – is shorter. Also it opens nearer the back passage than in men. Half of all women will have a urine infection that needs treating in their lifetime.
Urine infections are less common in men. They are very uncommon in young and middle-aged men. They are more common in older men. They are more likely to occur in men who have to use a catheter. A catheter is a thin, flexible, hollow tube used to drain urine. Older men are more likely to need a catheter because of prostate problems, which become more common with age.
Urine infections tend to become more common as you get older.
What Causes A Urinary Tract Infection
The main cause of UTIs, at any age, is usually bacteria. Escherichia coli is the primary cause, but other organisms can also cause a UTI.
In older adults who use catheters or live in a nursing home or other full-time care facility, bacteria such as Enterococci and Staphylococci are more common causes.
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Can I Prevent Urine Infections
Unfortunately, there are few proven ways to prevent urine infections. No evidence has been found for traditional advice given, such as drinking cranberry juice or the way you wipe yourself.
There are some measures which may help in some cases:
- It makes sense to avoid constipation, by eating plenty of fibre and drinking enough fluid.
- Older women with atrophic vaginitis may wish to consider hormone replacement creams or pessaries. These have been shown to help prevent urine infections.
- If there is an underlying medical problem, treatment for this may stop urine infections occurring.
- For some people with repeated urine infections, a preventative low dose of antibiotic taken continuously may be prescribed.
Major Causes Of Hematuria
Below are common causes of hematuria
- Kidney, bladder or prostate cancer
- Enlarged prostate
- Diseases of the ureter such as malignancy, stones, stricture
- Mimics of hematuria
- Vigorous exercise
It is important to remember the following the red colour change in urine does not necessarily reflect the degree of blood loss- so if you see blood in urine, do not panic and assume the patient will bleed to death. hematuria present with signs and symptoms of UTI is fairly common and transient, i.e. short-lasting. However, if you have a patient who presents with hematuria that is not explained by an obvious condition or persists beyond the UTI then you should refer the patient for further investigation.
The above highlights the importance of following up with patients with hematuria or any ailment for that matter- to confirm it has resolved or ensure appropriate referral where necessary.
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The Role Of Urinalysis And Uncomplicated Uti Diagnosis
Findings on a dipstick suggestive of UTI include either of the following leukocyte esterase or nitrites .
Other findings which may be present but not specific to UTI include hematuria- more common in the setting of UTI but not in urethritis or vaginitis. This can be helpful when differentiating between likely causes of symptoms cloudy urine may be evidence of infection foul urine odour- suggestive of bacteria in the urine.
Epidemiology Of Asymptomatic Bacteriuria
Asymptomatic bacteriuria is rare in younger people, but over the age of 75 years, it is found in 7â10% of men and 17â20% of women. A study among nursing home residents reported up to 25%-50% had ASB at any given time. Prevalence of ASB is 100% in patients with long-term indwelling catheters and about 3%â5% with short-term use.
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Urinary Tract Infections And Dementia
Urinary tract infections are a type of infection common among older people. If a person with a memory impairment or dementia has a UTI, this can cause sudden and severe confusion known as delirium.
Urinary tract infections and dementia
Utis Cause Unusual Behavioral Symptoms In Elders
Denise Altmans 81-year-old mother suffers from chronic depression, which often makes her sad and agitated. When her mom began acting confused during conversations over the phone and appearing glassy eyed in person, Altman and her sister assumed these were just symptoms of their moms underlying mental health issue. The confusion would last a few days and was often followed by a low-grade fever.
Finally, there was a breakthrough when their mother complained of painful urination during one of these odd spells. Altman took her mom to the doctor where she was diagnosed with a urinary tract infection . Unfortunately, the infection kept coming back, causing the sisters a great deal of concern.
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Urinary Tract Infection In The Elderly Patient: Epidemiology Presentation And Treatment
Michelle Blanda, MD, FACEP, Associate Professor of Emergency Medicine, Northeastern Ohio Universities College of Medicine/Summa Health System, Akron, OH.
Peer Reviewer: Rita Kay Cydulka, MD, FACEP, Associate Professor, Department of Emergency Medicine, Case Western Reserve University, MetroHealth Medical Center, Cleveland, OH.
Elderly patients represent a heterogeneous group, ranging from individuals in the community who are clinically well and fully functional to those who are impaired, non-communicative, immobile nursing home residents. A common cause for emergency presentation in this age group is infection.
Urinary tract infections with respiratory infections are the most common cause of bacteremia in the elderly.1-4 This is true for the community-dwelling elder, as well as for the institutionalized elderly patient. For the emergency department physician, this diagnosis often is a challenge. UTIs in the older population may present in an obscure manner. Patients in this age group tend to have multiple medical problems and can present with multiple somatic complaints. Conversely, physicians must be careful to not prematurely assign the diagnosis of UTI to a patient who actually has a different source of infection or another problem.
What Are Recurrent Urinary Tract Infections
A recurrent urinary tract infection is an infection that comes back after you have been treated for a previous UTI.
The causes of recurrent urinary tract infections are usually due to the bacteria that cause the initial infection not being completely eradicated from the body. This can happen if you do not finish the full course of antibiotics prescribed or if the bacteria are resistant to the antibiotics used.
Symptoms of recurrent urinary tract infections can vary depending on the individual but may include frequent urination, burning sensation when urinating, cloudy or bloody urine, and pelvic pain.
Treatment of recurrent urinary tract infections usually involves re-treatment with the same antibiotics that were used to treat the initial infection. However, if the bacteria are resistant to the first line of antibiotics, your healthcare provider may prescribe a different antibiotic.
Prevention of recurrent urinary tract infections can be achieved by taking measures to reduce your risk of developing an infection in the first place. This includes drinking plenty of fluids, urinating regularly, and wiping from front to back after using the toilet. You may also be prescribed a prophylactic antibiotic to take after you have been treated for a UTI.
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