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Confusion Strongly Associated with Antibiotic Prescribing Due to Suspected Urinary Tract Infections in Nursing Homes
Author(s) -
Mayne Sean,
Sundvall PärDaniel,
Gunnarsson Ronny
Publication year - 2018
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.15179
Subject(s) - medicine , antibiotics , urinary system , confusion , population , pediatrics , intensive care medicine , environmental health , psychology , psychoanalysis , microbiology and biotechnology , biology
Objectives To quantify the prevalence of documented urinary tract infection ( UTI ), nonspecific symptoms, and antibiotic treatment of suspected UTI in nursing homes ( NH s) in the tropics and to describe the typical resident likely to receive antibiotic treatment for suspected UTI and factors associated with the development of confusion, fatigue, and restlessness. Design Cross‐sectional. Setting Five far north Queensland NH s in tropical Australia. Participants NH residents (N = 450). Measurements Chart reviews of NH residents between August 28, 2015, and June 21, 2016, to determine the prevalence of documented UTI , new or worsening nonspecific and specific symptoms that are specific or nonspecific to the urinary tract, antibiotic use, medical conditions, and medication factors. Results UTI accounted for 33% of all current infections treated with antibiotics and 40% of all infections treated with antibiotics within the last 30 days. One in 5 NH residents had received antibiotics within the last 30 days, of which 45% were for UTI . The most significant factors independently associated with antibiotics for UTI were urinary catheter ( OR = 13, 95% CI = 2.4–67, P = .003), urinary frequency ( OR = 10, 95% CI = 2.2–47, P = .003), fever ( OR = 10, 95% CI = 1.3–85, P = .028), new‐onset hypotension ( OR = 10, 95% CI = 1.4–73, P = .024), and confusion ( OR = 8.9, 95% CI = 3.1–26, P < .001). Of these, confusion was the most prevalent factor in the population. Conclusion UTI is commonly documented in NH residents, with new or worsening confusion being one of the strongest factors associated with antibiotic treatment for suspected UTI .