Diagnosis, Treatment, and Prevention of Urinary Tract Infections in Post-Acute and Long-Term Care Settings: A Consensus Statement From AMDA's Infection Advisory Subcommittee

2020 ◽  
Vol 21 (1) ◽  
pp. 12-24.e2 ◽  
Author(s):  
Muhammad S. Ashraf ◽  
Swati Gaur ◽  
Oluma Y. Bushen ◽  
Teena Chopra ◽  
Philip Chung ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Long Term Care ◽  
Consensus Statement ◽  
Term Care ◽  
Treatment And Prevention ◽  
Tract Infections

Urinary Tract Infections in Long-Term Care Residents

2011 ◽  
Vol 27 (2) ◽  
pp. 229-239 ◽  
Author(s):  
Gwendolen T. Buhr ◽  
Liza Genao ◽  
Heidi K. White
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Long Term Care ◽  
Term Care ◽  
Tract Infections

Pharmacoepidemiology of Urinary Tract Infections in Iowa Medicaid Patients in Urban Long-Term-Care Facilities

1997 ◽  
Vol 31 (7-8) ◽  
pp. 837-841 ◽  
Author(s):  
Darrel C. Bjornson ◽  
John P. Rovers ◽  
Julie A. Burian ◽  
Nancy L. Hall
Keyword(s):  
Urinary Tract ◽  
Patient Outcomes ◽  
Urinary Tract Infections ◽  
Long Term Care ◽  
Treatment Preference ◽  
Term Care ◽  
Care Facilities ◽  
Tract Infections

OBJECTIVE: To describe the therapeutic management of Medicaid patients with urinary tract infections (UTIs) in urban long-term-care facilities (LTCFs) and to link individual therapies to patient outcomes. DESIGN: Retrospective review of medical records in LTCFs of patients who had documented UTIs. METHODS: Patient data were collected from 17 LTCFs in the Des Moines, IA, metropolitan area during a 1-year period starting January 1, 1995. Patients with UTIs were selected from the LTCF infection control logs. Data collected on patients included demographics, concomitant diseases, type of UTI (i.e., symptomatic, asymptomatic, catheter-related), process measures for management, UTI treatment, patient outcomes, and follow-up. Patient outcome data were defined as either cure or no cure. A UTI cure was defined as a negative urine culture while taking antibiotic therapy and/or complete resolution of signs and symptoms, as well as no further treatment given within 2 weeks after the end of treatment. RESULTS: Data were collected on 310 patients who had at least one UTI over the 1-year study period. Patients were primarily elderly (mean age 82.2 ± 12.3 y), white (95.1%), and female (83.9%). Concomitant diseases were common and about one-fourth (23.0%) of the patients were catheterized. There were 536 UTI events (the unit of analysis) documented over the 1-year period, with about one-half (45.9%) being UTIs with symptoms consistent with uncomplicated lower UTI. Nearly two-thirds (62.3%) of the patients were cured, based on the study definition; there was no association between cure and type of antimicrobial therapy (p = 0.99). Over one-third (35.2%) of the UTIs were treated with a quinolone antibiotic. Others were treated with trimethoprim/sulfamethoxazole (24.4%), nitrofurantoin (13.9%), a cephalosporin (10.4%), or ampicillin/amoxicillin (9.8%). Sixty-day follow-up showed no association between type of therapy and hospital readmission, physician follow-up visits, or subsequent UTIs. CONCLUSIONS: There were no differences in cure rates when comparing LTCF UTI patients receiving various regimens. With outcomes being the same, the clinician should closely consider costs of drug therapy in selecting a treatment preference.

scholarly journals A Systematized Review of UTI Management Protocol for Long-Term Care Residents

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 87-87
Author(s):  
Akanksha Arora ◽  
N Ruth Gaskins Little
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Practice Guidelines ◽  
Long Term Care ◽  
The Elderly ◽  
Nurse Specialist ◽  
Term Care ◽  
Management Protocol ◽  
Tract Infections

Abstract Clinical acuity for the elderly population has significantly intensified. This population is at heightened risk of infection, especially urinary tract infections (UTIs). Urinary tract infections exist as a clinical leviathan in the long-term care (LTC) industry and, despite its high prevalence rates, there exists a dearth of research on management protocol. The following review aims to summarize the current literature, identify, and comparatively analyze the current UTI management guidelines among LTC residents to guide provider leadership development of standards to prevent UTIs. The Joanna Briggs Institute’s approach to systematic reviews was implemented to search the following databases: ProQuest, PubMed, CINAHL, and MEDLINE. 538 citations were assessed, with 32 articles included in the review. Inclusion criteria comprised of clinical trial studies, a time frame of 2005 to current, and no restriction on the study country/region. Key results were collected and analyzed using a data extraction tool. Study findings show that consistent protocols are not followed by licensed staff to prevent, diagnose, and treat UTI’s among the elderly residing in long term care facilities. Inappropriate use of antibiotics is problematic due to the lack of specific practice guidelines for testing, diagnosis and, treatment. Studies implementing (1) successful clinical management strategies (i.e. antibiotic initiation, urinalysis frequency) and (2) facility administrative strategies (i.e. incontinence nurse specialist, DON/nurse leadership education) are needed to establish gold standard practice guidelines for the LTC industry.

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