Take a few minutes to read this interesting blog posting by our colleagues at our U.S. chapter, LeadingAge.  The findings in this study are  based on observations in the U.S. State of Rhode Island.  Have you observed similar situations in your community?  What steps can nursing homes to correct this problem?

According to new research out of Brown University, many nursing home residents may be receiving inappropriate treatment for urinary tract infections (UTIs) which can affect more than their bladder health.

Brown researchers, lead by Dr. David Dosa, chronicled 172 cases of suspected UTIs in two Rhode Island nursing homes over six months. During that time, only 26 people met the criteria for antibiotic treatment for their UTIs, but 70 were inappropriately prescribed antibiotics.  Further, 69 individuals received inappropriate antibiotics based on the Infectious Disease Society of America criteria, 44 received an inappropriate and 64 people received treatment for longer than recommended.

One could say this sample is too small to identify a national trend, but it’s highly likely that some nursing home residents are being treated inappropriately for UTIs. However, the risks associated with poor UTI treatment can be deadly. Overuse of antibiotics can lead to drug-resistant bacteria and increase the risk of hard-to-treat infections, Dosa notes in the study. Anecdotally, nursing home staff report that a resident with a UTI, particularly with low mobility, may be at a higher risk for pressure ulcers and infections because of their inability to move quickly enough to the bathroom. Those who do try to make it to the bathroom may fall, another harmful injury to an older adult.

Researchers recommend that individuals err on the side of caution when it comes to treating a UTI with antibiotics. “Patients and relatives should allow doctors to make educated decisions based on existing guidelines,” rather than asking for antibiotics as soon as patients get an infection, Dosa said.

This study appears in the March 2011 edition of the Archives of Internal Medicine.

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