Ditch the Dipstick – for patients >65Yrs or Catheterised!
Approx. 50% of over 65’s and most of those with catheters have asymptomatic bacteriuria. The patient will not benefit from treatment and often gives us premature closure (i.e. we blame a fictitious UTI for the patients symptoms and stop thinking).
- Think Sepsis! – If the patient is septic treat as guidance
- Look for Signs & Symps of UTI – us the indicators below
- New dysuria (alone)
- OR 2 of the following:
- Temp 1.5°C above their norm (twice in 12hr) OR Hypothermia
- New frequency/urgency
- New incontinence
- New/Worsening delirium/debility*
- New suprapubic/flank pain
- Visible haematuria
- Consider UTI in older patients with: pyrexia, hypothermia, abnormal WCC or CRP AND no alternative cause for these.
*Confusion does not always mean infection. Consider other causes such as dehydration, constipation, medication etc.
- Only treat based on documented clinical signs and symptoms.
- Send an MSU for culture before commencing antibiotics.
- Follow antibiotic guidance