BMJ 2014;349:g5636 doi: 10.1136/bmj.g5636 (Published 18 September 2014)
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Letters
LETTERS SUSPECTED UTI IN OLDER PEOPLE
An accurate history is particularly important in older people with suspected urinary tract infection Phil J R Taylor general practitioner Kilmington, UK
Ninan and colleagues’ article on investigating suspected urinary tract infection in older people seems to be written from a hospital perspective and does not take into account the fact that, in most cases of urinary tract infection in elderly women, it is not always best to wait for the result of midstream urine testing.1 GPs are often in a position where a patient who is at high risk and has fallen is mildly confused and unwell. Although a midstream urine test can be sent, it can take several days for the result to come back. A dipstick test can point the clinician in the right direction and allow treatment to be started, even if the specificity of this approach is relatively low. Such patients can then be provided with care packages in their own home. Evidence shows—particularly in those with dementia—that
admission to hospital can result in prolonged stays and often institutionalisation.
The real message from this case is that an accurate history is particularly important in older people, even when the patient cannot provide it. In this particular case, this could have identified her confusion as coinciding with her new prescription, and she could have been managed without hospital admission. Competing interests: None declared. 1
Ninan S, Walton C, Barlow G. Investigation of suspected urinary tract infection in older people. BMJ 2014;349:g4070. (3 July.)
Cite this as: BMJ 2014;349:g5636 © BMJ Publishing Group Ltd 2014
[email protected] For personal use only: See rights and reprints http://www.bmj.com/permissions
Subscribe: http://www.bmj.com/subscribe
Page 1 of 1
Letters
LETTERS SUSPECTED UTI IN OLDER PEOPLE
An accurate history is particularly important in older people with suspected urinary tract infection Phil J R Taylor general practitioner Kilmington, UK
Ninan and colleagues’ article on investigating suspected urinary tract infection in older people seems to be written from a hospital perspective and does not take into account the fact that, in most cases of urinary tract infection in elderly women, it is not always best to wait for the result of midstream urine testing.1 GPs are often in a position where a patient who is at high risk and has fallen is mildly confused and unwell. Although a midstream urine test can be sent, it can take several days for the result to come back. A dipstick test can point the clinician in the right direction and allow treatment to be started, even if the specificity of this approach is relatively low. Such patients can then be provided with care packages in their own home. Evidence shows—particularly in those with dementia—that
admission to hospital can result in prolonged stays and often institutionalisation.
The real message from this case is that an accurate history is particularly important in older people, even when the patient cannot provide it. In this particular case, this could have identified her confusion as coinciding with her new prescription, and she could have been managed without hospital admission. Competing interests: None declared. 1
Ninan S, Walton C, Barlow G. Investigation of suspected urinary tract infection in older people. BMJ 2014;349:g4070. (3 July.)
Cite this as: BMJ 2014;349:g5636 © BMJ Publishing Group Ltd 2014
[email protected] For personal use only: See rights and reprints http://www.bmj.com/permissions
Subscribe: http://www.bmj.com/subscribe
