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Sidan uppdaterades: 2012-09-11 15:12
Författare |
Laura W van Buul Hilde L Vreeken Suzanne F Bradley Christopher J Crnich Paul J Drinka Suzanne E Geerlings Robin L P Jump Lona Mody Joseph J Mylotte Mark Loeb David A Nace Lindsay E Nicolle Philip D Sloane Rhonda L Stuart Pär-Daniel Sundvall Peter Ulleryd Ruth B Veenhuizen Cees M P M Hertogh |
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Publicerad i | Journal of the American Medical Directors Association |
Volym | 19 |
Nummer/häfte | 9 |
Sidor | 757-764 |
ISSN | 1538-9375 |
Publiceringsår | 2018 |
Publicerad vid |
Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa |
Sidor | 757-764 |
Språk | en |
Länkar |
dx.doi.org/10.1016/j.jamda.2018.05.... www.ncbi.nlm.nih.gov/entrez/query.f... |
Ämneskategorier | Allmän medicin, Geriatrik, Infektionsmedicin |
Nonspecific signs and symptoms combined with positive urinalysis results frequently trigger antibiotic therapy in frail older adults. However, there is limited evidence about which signs and symptoms indicate urinary tract infection (UTI) in this population. We aimed to find consensus among an international expert panel on which signs and symptoms, commonly attributed to UTI, should and should not lead to antibiotic prescribing in frail older adults, and to integrate these findings into a decision tool for the empiric treatment of suspected UTI in this population.A Delphi consensus procedure.An international panel of practitioners recognized as experts in the field of UTI in frail older patients.In 4 questionnaire rounds, the panel (1) evaluated the likelihood that individual signs and symptoms are caused by UTI, (2) indicated whether they would prescribe antibiotics empirically for combinations of signs and symptoms, and (3) provided feedback on a draft decision tool.Experts agreed that the majority of nonspecific signs and symptoms should be evaluated for other causes instead of being attributed to UTI and that urinalysis should not influence treatment decisions unless both nitrite and leukocyte esterase are negative. These and other findings were incorporated into a decision tool for the empiric treatment for suspected UTI in frail older adults with and without an indwelling urinary catheter.A decision tool for suspected UTI in frail older adults was developed based on consensus among an international expert panel. Studies are needed to evaluate whether this decision tool is effective in reaching its aim: the improvement of diagnostic evaluation and treatment for suspected UTI in frail older adults.