Abstract: Urinary tract infections (UTI) occur frequently in older people. Unfortunately,
UTI is commonly overdiagnosed and overtreated on the basis of nonspecific clinical signs and
symptoms. The diagnosis of a UTI in the older patient requires the presence of new urinary
symptoms, with or without systemic symptoms. Urinalysis is commonly used to diagnose
infection in this population, however, the evidence for its use is limited. There is overwhelming
evidence that asymptomatic bacteriuria should not be treated. Catheter associated urinary
tract infection accounts for a significant amount of hospital-associated infection. Indwelling
urinary catheters should be avoided where possible and alternatives sought. The use of narrow
spectrum antimicrobial agents for urinary tract infection is advocated. Local guidelines are
now widely used to reflect local resistance patterns and available agents. Guidelines need to
be updated to reflect changes in antimicrobial prescribing and a move from broad to narrow
spectrum antimicrobials.
Keywords: urinary tract infection, elderly, review