Urinary tract infections in elderly women

Urinary tract infections (UTIs) are very common in the elderly. It is the most frequent bacterial infection recorded in the elderly, followed by pneumonia and skin/soft tissue infections. Bacteriuria is present in less than 5% of women and less than 0.1% of men in the young to middle-age age range, compared with at least 20% of women and 10% of men over the age of 65. In this Cochrane review the methodological quality of all trials was low. However, the rate of persistent bacteria at long- term and the clinical cure rate showed no statistically significant difference between the two groups. Patients pre- ferred single dose treatment, however this was based on one trial comparing different antibiotics. The antibiotics used in this review that are available in New Zealand were ciprofloxacin, norfloxin, trimethoprim and sulph- metizol. The definition of elderly was women over the age of 60 years. Bottom line: There is a theoreti- cal risk of recurrence in giving sin- gle dose antibiotics to women over the age of 60 years. With treatment for three to 14 days this is less likely. The research does not show an in- crease in side effects with longer treatment but common sense should prevail and perhaps use shorter courses than 14 days. Three day minimum may be acceptable to both clinician and patient.