Confusion strongly associated with antibiotic prescribing due to suspected urinary tract infections in nursing homes

Mayne, Sean, Sundvall, Paer-Daniel, and Gunnarsson, Ronny (2018) Confusion strongly associated with antibiotic prescribing due to suspected urinary tract infections in nursing homes. Journal of the American Geriatrics Society, 66 (2). pp. 274-281.

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Objectives: To quantify the prevalence of documented urinary tract infection (UTI), nonspecific symptoms, and antibiotic treatment of suspected UTI in nursing homes (NHs) in the tropics and to describe the typical resident likely to receive antibiotic treatment for suspected UTI and factors associated with the development of confusion, fatigue, and restlessness.

Design: Cross-sectional.

Setting: Five far north Queensland NHs in tropical Australia.

Participants: NH residents (N=450).

Measurements: Chartreviews of NH residents between August 28, 2015, and June 21, 2016, to determine the prevalence of documented UTI, new or worsening nonspecific and specific symptoms that are specific or nonspecific to the urinary tract, antibiotic use, medical conditions, and medication factors.

Results: UTI accounted for 33% of all current infections treated with antibiotics and 40% of all infections treated with antibiotics within the last 30days. One in 5 NH residents had received antibiotics within the last 30days, of which 45% were for UTI. The most significant factors independently associated with antibiotics for UTI were urinary catheter (OR=13, 95% CI=2.4-67, P=.003), urinary frequency (OR=10, 95% CI=2.2-47, P=.003), fever (OR=10, 95% CI=1.3-85, P=.028), new-onset hypotension (OR=10, 95% CI=1.4-73, P=.024), and confusion (OR=8.9, 95% CI=3.1-26, P<.001). Of these, confusion was the most prevalent factor in the population.

Conclusion: UTI is commonly documented in NH residents, with new or worsening confusion being one of the strongest factors associated with antibiotic treatment for suspected UTI.

Item ID: 53441
Item Type: Article (Research - C1)
ISSN: 1532-5415
Keywords: urinary tract infection, confusion, antibiotics, nursing homes
Funders: Far North Queensland Hospital Foundation, James Cook University (JCU)
Projects and Grants: JCU College of Medicine and Dentistry
Date Deposited: 07 Mar 2018 07:33
FoR Codes: 42 HEALTH SCIENCES > 4203 Health services and systems > 420301 Aged health care @ 100%
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