Antibiotics May Not Be Needed for Older Patients with Urinary Tract Infections

By Jane Farrell

Prescribing antibiotics for urinary tract infections may not be necessary for older patients, according to new research.

That conclusion was reached by Thomas E. Finucane, MD, of the Johns Hopkins Geriatrics Center at Johns Hopkins in Baltimore. The finding was published in the Journal of the American Geriatrics Society.

According to a news release from the American Geriatrics Society, urinary tract infection (“UTI”) is a vague, overused diagnosis that may be applied to older adults who have no symptoms but may have bacteria in the urine and also may be experiencing confusion, falls, or other vague signs (including changes in the odor or color of urine). In most cases, antibiotics do not benefit these older people and in some cases may even be harmful, the news release said.

Researchers are coming to a new understanding about the kinds of bacteria, viruses, and other microorganisms that live in the human body naturally. It’s now known that everyone’s urine contains bacteria and viruses, for example. We also know that these microorganisms are usually helpful to overall well-being.

However, the news release emphasized that some groups of people do still benefit from antibiotic treatment of UTIs. The treatment is beneficial to:

• People who are sick enough to require urgent antibiotic treatment regardless of findings in the urine.
• People with invasive bacterial diseases, especially kidney infections.
• Pregnant women and people about to have bladder or urinary tract surgery.

In his paper, Finucane says that microbiome studies–which examine the benefits and harms caused by the billions of organisms that naturally live in the human body–suggest that UTI treatment with antibiotics actually may be more harmful than we previously thought. If you think you have a UTI, or if you’re currently using an antibiotic to treat a UTI, it’s important to speak with a healthcare professional first before changing your care plan. Your doctor, nurse, or other provider can work with you to find a treatment plan that’s best for you.