Some urinary tract infections heal on their own, without antibiotics. But in the elderly, it is better not to take the risk.
Prescribing antibiotics immediately to elderly patients with urinary tract infections (or cystitis) is associated with a reduced risk of sepsis and death, compared to patients who receive antibiotics within days of diagnosis, or who do not. not receive at all.
Those are latest results produced by Imperial College London, published in the BMJ. Concretely, this will help doctors to make clinical decisions about the most appropriate time to prescribe antibiotics to the elderly.
Eight times more likely to develop a fatal infection
As part of this research, the team looked at the records of 157,264 English people over the age of 65 with UTIs. Some patients had been prescribed antibiotics immediately (87% of the cases studied), had delayed their treatment for 7 days (6% of the cases) or had taken no medication (7% of the cases).
Among patients who took antibiotics immediately, only 0.2% developed sepsis within 60 days. In contrast, patients whose antibiotic prescription was delayed or who took no antibiotics were up to eight times more likely to develop this deadly infection.
Risk of death
1.6% of patients who received antibiotics immediately died within 60 days. The risk of death over the same period in patients whose prescription of antibiotics was delayed increased slightly (16%), while the risk doubled in patients who took no antibiotics.
Overuse of antibiotics should be “avoided, as urinary tract infections can sometimes improve without medication. However, our research suggests that antibiotics should not be delayed in elderly patients,” concludes the study director. Cystitis is a urinary tract infection located in the bladder. Most often, it is caused by the bacterium Escherichia Coli.
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