Constitutional Symptoms Often Trigger Antibiotic Rx in Elderly

This article originally appeared here.
Share this content:
Constitutional Symptoms Often Trigger Antibiotic Rx in Elderly
Constitutional Symptoms Often Trigger Antibiotic Rx in Elderly

THURSDAY, Sept. 29, 2016 (HealthDay News) -- Constitutional symptoms, including mentation, often lead to diagnostic testing and potentially inappropriate antibiotic prescribing in older patients suspected of having a urinary tract infection (UTI) or pneumonia, according to a study published online Sept. 22 in the Journal of the American Geriatrics Society.

Angela C. Eke-Usim, M.D., M.P.H., from the University of Michigan in Ann Arbor, and colleagues examined the use of diagnostic testing before treating an infection in nursing home (NH) residents suspected of having UTI or pneumonia. Data were included for 162 NH residents with an indwelling urinary catheter, enteral feeding tube, or both. There were 695 follow-up visits, including 28 percent with an infection.

The researchers found that 100 NH residents (62 percent) had an incident infection necessitating antibiotic treatment, with considerable variation between NHs. Change in function significantly predicted ordering a chest X-ray to detect pneumonia (odds ratio, 1.7), as well as the presence of infection-specific symptoms. Change in mentation significantly predicted ordering a urinalysis, chest X-ray, and blood culture (odds ratios, 1.9, 3.3, and 2.3, respectively). In 21.5 percent of 233 suspected UTI cases and 30.2 percent of 53 suspected pneumonia cases, antibiotics were used empirically, before laboratory results were available. In 17 percent of visits without documented clinical or laboratory evidence of infection, antibiotics were used.

"Antibiotic use often continues despite negative test results and should be a target for future interventions," the authors write.

Abstract
Full Text (subscription or payment may be required)

Share this content:

is free, fast, and customized just for you!

Already a member?

Sign In Now »


Sign up for myCME e-newsletters


Drug Lookup

Browse drugs by: BrandGenericDisease

More in Home

FDA Approves Actemra to Treat Giant Cell Arteritis

FDA Approves Actemra to Treat Giant Cell Arteritis

New indication provides the first FDA-approved therapy specific to this type of vasculitis

Trends in Teen Binge Drinking Still Raise Concerns

Trends in Teen Binge Drinking Still Raise Concerns

Even though frequent binge drinking among adolescents has dropped in past 25 years

ATS: First Abx Rx Doesn't Work for 25 of Pneumonia Cases

ATS: First Abx Rx Doesn't Work for ~25% ...

One in four adult patients do not respond to initial prescription of antibiotic treatment

is free, fast, and customized just for you!

Already a member?

Sign In Now »