In This Episode:
Dr. K explains why having bacteria in one’s urine does NOT mean one has a urinary tract infection (UTI) that requires antibiotics. In fact, as people get older, they may have bacteria in the urine but no UTI symptoms or other signs of infection. This condition, called “asymptomatic bacteriuria” is common, and is often inappropriately treated with antibiotics. In this episode:
- How to know if one has asymptomatic bacteriuria versus a UTI that warrants antibiotics
- Why having asymptomatic bacteriuria becomes more common as people become older
- Why the Infectious Disease Society of America and others have repeatedly urged doctors to NOT treat asymptomatic bacteriuria
- The challenge of correctly diagnosing UTIs in people with dementia
- How one can be harmed by using antibiotics to try to eliminate bacteria in the bladder
- What to do if you’re worried about urine bacteria — or a possible UTI — in an older person
Related episode:
014 – Delirium & Hospital Confusion
Related Resources:
- Why Urine Bacteria Doesn’t Mean a UTI Needs Antibiotics
- Choosing Wisely Recommendations of the Infectious Disease Society of America
- 26 Recommended Preventive Health Services for Older Adults
- Approach to a Positive Urine Culture in a Patient Without Urinary Symptoms
- Diagnosis and Management of Urinary Tract Infection in Older Adults
- “Urinary Tract Infection”—Requiem for a Heavyweight
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Hi Dr K!
I had asked a question a while ago re: asymptomatic bacteriuria and the use of Hiprex and Vitamin C for treatment. I did get your answer, but hadn’t responded to you! Anyway, my Mum went to the urologist for a 3 month check up, and Dr. N was pleased with her progress. They apparently do not repeat a culture, because it’s a colonized situation. They just ask if she’s having symptoms; fever, burning, frequency. I told him I had a concern about her being on Hiprex long term, and he said it was actually safer than using antibiotics. I think he was surprised I had looked up the action, and agreed it does sound scary, so he doesn’t usually disclose the action to his patients (I disagree with this-everyone should be informed of what they’re taking). Me being a nurse of course I had to look it up! Mum seems to be tolerating it well, but the odor of the urine hasn’t changed, and since I’m sensitive to odors, cleaning her commode isn’t pleasant, but it’s short-lived! Thanks again for your input!
Thanks for sharing this update. I’m glad your mom is doing ok.
For anyone else who is interested Hiprex or other aspects of this topic, see here.