Q: An older friend, who is in her 90s, has been having bacteria in her urine, but no symptoms. Despite treatment with antibiotics, she was still having urine in the bacteria, so the doctor recommended chronic antibiotics and a referral to urology.

What can be done when an elderly woman has bacteria in her urine but no symptoms? Can a urology consultation help?

A: This is a great question. You are describing something called asymptomatic bacteriuria, which means having urine bacteria without symptoms.

Every older person and family caregiver should know about asymptomatic bacteriuria. Here’s why:

• It’s very common in older adults. This condition is found in an estimated 20% of women aged 80 or older, and also affects older men. The older the person, the more common it is.

• It’s often confused with a urinary tract infection (UTI).  This can lead to unnecessary — and potentially harmful — treatment with antibiotics.

• It usually does NOT need to be treated with antibiotics. As I’ll explain below, research shows that people don’t live better or longer when asymptomatic bacteriuria is treated. In fact, such treatment can be harmful: one study found that treatment increased the risk of future (real) UTIs, and increased the risk of infection with antibiotic-resistant bacteria.

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