Introduction. Generally, a UTI requires treatment if significant amounts of one or more organisms are present in the urine. In geriatrics, bacteriuria alone frequently is insufficient to diagnose a UTI and does not always require antimicrobial treatment.
Older adults should have other symptoms, too Fever over 100.5 °F. Worsening urinary frequency or urgency. Sudden pain with urination. Tenderness in the lower abdomen, above the pubic bone.
When left untreated, UTIs in the elderly can cause serious problems, including permanent kidney damage and sepsis — a generalized and potentially life-threatening infection. Read on to understand how UTIs can affect the elderly and how to recognize symptoms of this common infection.
The medications commonly used to treat uncomplicated UTIs in the elderly are listed in the Table. Trimethoprim-sulfamethoxazole (TMP-SMX). For years, this has been considered the first-line agent for treatment of uncomplicated UTIs.
You should only get tested or treated if UTI symptoms come back. Antibiotics have side effects. Antibiotics can have side effects, such as fever, rash, diarrhea, nausea, vomiting, headache, tendon ruptures, and nerve damage. Antibiotics can cause future problems.
Antibiotics are the treatment of choice for UTIs in older adults and younger people. Your doctor may prescribe amoxicillin and nitrofurantoin (Macrobid, Macrodantin). More severe infections may require a broad-spectrum antibiotic such as ciprofloxacin (Cetraxal, Ciloxan) and levofloxacin (Levaquin).
Seniors experiencing UTIs can show a sudden change in behavior and symptoms that may appear to be associated with cognitive issues, such as:
Symptoms of urosepsis include:
To treat a UTI without antibiotics, people can try the following home remedies:
Three days of trimethoprim-sulfamethoxazole is recommended as standard UTI therapy for otherwise healthy women. Fluoroquinolones are only recommended as first-line empirical therapy in communities with trimethoprim-sulfamethoxazole resistance rates greater than 10% to 20%.
Temafloxacin: a safe antibiotic for the elderly, patients with comorbidities, and other special populations.
Symptoms of a UTI may include:
First-line antibiotics for acute, uncomplicated urinary tract infections (UTIs) typically include: Fosfomycin. Nitrofurantoin. Trimethoprim or sulfamethoxazole (Bactrim)
How long you take antibiotics for a UTI depends on how severe your UTI is and which antibiotic you’re prescribed. Some medications like fosfomycin only require one dose, while a more severe UTI might require 14 days — or more — of treatment. Most require 3 to 7 days of treatment.
Antibiotics are not available without a prescription in the United States. You will need to talk to a doctor or nurse practitioner to get a prescription. You can do this in person, over the phone, or over video. If this is your first UTI, it can be helpful to see a doctor in person.