Antibiotics for Urinary Tract Infections in Older People

Antibiotics are medicines that can kill bacteria. Health care providers often use antibiotics to treat urinary tract infections (UTIs).

The main symptom of a UTI is a burning feeling when you urinate.

However, many older people get UTI treatment even though they do not have these symptoms. This can do more harm than good. Here’s why:

Antibiotics usually don’t help when there are no UTI symptoms.

Older people often have some bacteria in their urine. This does not mean they have a UTI. But health care providers may find the bacteria in a routine test and give antibiotics anyway.

The antibiotic does not help these patients.

• It does not prevent UTIs.
• It does not help bladder control.
• It does not help memory problems or balance.

Most older people should not be tested or treated for a UTI unless they have UTI symptoms. And if you do have a UTI and get treated, you usually don’t need another test to find out if you are cured. You should also not be tested ‘just in case’ there is a UTI.

You should only get tested or treated if UTI symptoms come back.

Antibiotics can have side effects, such as fever, rash, diarrhea, nausea, vomiting, headache, tendon ruptures, and nerve damage.

Antibiotics can cause future problems.

Antibiotics can kill “friendly” germs in the body. This can lead to vaginal yeast infections. It can also lead to other infections, severe diarrhea, hospitalization, and even death.

Also, antibiotics may help “drug-resistant” bacteria grow. These bacteria are harder to kill. They cause illnesses that are harder to cure. Your health care provider may have to try several antibiotics. This increases the risk of complications. The resistant bacteria can also be passed on to others. If you get an infection from resistant bacteria, you may need more visits and medicines that cost more.

When should older people take antibiotics for a UTI?

If you have UTI symptoms, antibiotics can help.

• The most common UTI symptom is a painful, burning feeling when you urinate.
• Other UTI symptoms in older people may include fever, urge to urinate, and frequent urination. Along with these symptoms, there can be pain on one side of the back below the ribs or discomfort in the lower abdomen.

Some kinds of surgery can cause bleeding in the urinary tract—for example, prostate surgery and some procedures to remove kidney stones or bladder tumours. If you are going to have this surgery, you may need testing and treatment for bacteria in urine.

Drink water. Most healthy people should remain adequately hydrated which means drinking enough water to avoid thirst. If you have kidney failure, you should talk to your health care provider about how much to drink.

Don’t hold it in. If urine stays in the bladder too long, infections are more likely. Try to urinate when you first feel the need.

Use good hygiene.

• After a bowel movement, women should wipe from front to back, to avoid bringing bacteria into the urinary tract.
• Both men and women should urinate after sex to flush out bacteria.

Use urinary catheters briefly, if at all.

• Catheters are tubes put into the bladder to help with bladder control. They increase the risk of infection.
• Some people in long-term care, such as nursing homes, have catheters. They can be helpful in specific bladder conditions such as urinary obstruction or for comfort near the end of life. In other cases, ask caregivers or your health care provider to manage bladder-control problems without a catheter.
• If you are in the hospital with a urinary catheter, ask your health care provider if it can be removed as soon as Even a few days with a catheter increases the risk of infection.