0
February 27, 1987, Vol 257, No. 8 >
ARTICLE | February 27, 1987

Therapy vs No Therapy for Bacteriuria in Elderly Ambulatory Nonhospitalized Women FREE

Jerome A. Boscia, MD; William D. Kobasa, MS; Ralph A. Knight, PhD; Elias Abrutyn, MD; Matthew E. Levison, MD; Donald Kaye, MD
[+] Author Affiliations

Reprint requests to The Medical College of Pennsylvania, 3300 Henry Ave, Philadelphia, PA 19129 (Dr Boscia).


JAMA. 1987;257(8):1067-1071. doi:10.1001/jama.1987.03390080057030
Text Size: A A A
Published online
Article
References

This prospective randomized study was undertaken to determine the efficacy of antimicrobial therapy compared with no therapy for bacteriuria in elderly ambulatory nonhospitalized women. Sixty-one women (mean age, 85.8 years) with bacteriuria were in the no therapy control group and 63 women (mean age, 85.8 years) with bacteriuria were in the therapy group; none had symptoms of urinary tract infection. One short course of antimicrobial therapy achieved a cure rate of 68.3% (43 of 63 women cured) two weeks after treatment. During the six-month follow-up period, ten (16.4%) of 61 women in the no therapy group and five (7.9%) of 63 women in the therapy group developed symptomatic urinary tract infection. At the time of six-month follow-up, 19 (34.5%) of 55 women in the no therapy group and 35 (63.6%) of 55 women in the therapy group did not have bacteriuria. We conclude that for asymptomatic bacteriuria in elderly ambulatory nonhospitalized women, short-course antimicrobial therapy is effective at two-week follow-up and that antimicrobial therapy can eliminate bacteriuria in most of these women for at least a six-month period.

(JAMA 1987;257:1067-1071)

REFERENCES

1 +
Sourander LB:  Urinary tract infection in the aged: An epidemiological study . Ann Med Intern Fenn 1966;;55( (suppl 45) ):7-55.
2 +
Brocklehurst JC, Dillane JB, Griffiths L, et al:  The prevalence and symptomatology of urinary infection in an aged population . Gerontol Clin 1968;;10:242-253.
3 +
Akhtar AJ, Andrews GR, Caird FI, et al:  Urinary tract infection in the elderly: A population study . Age Ageing 1972;;1:48-54.
4 +
Kasviki-Charvati P, Drolette-Kefakis B, Papanayiotou PC, et al:  Turnover of bacteriuria in old age . Age Ageing 1982;;11:169-174.
5 +
Boscia JA, Kobasa WD, Knight RA, et al:  Epidemiology of bacteriuria in an elderly population . Am J Med 1986;;80:208-214.
6 +
Wolfson SA, Kalmanson GM, Rubini ME, et al:  Epidemiology of bacteriuria in a predominantly geriatric male population . Am J Med Sci 1965;;250: 168-173.
7 +
Klarskov P:  Bacteriuria in elderly women . Dan Med Bull 1976;;23:200-204.
8 +
Boscia JA, Kobasa WD, Abrutyn E, et al:  Lack of association between bacteriuria and symptoms in the elderly . Am J Med 1986;;81:979-982.
9 +
Kaye D:  Urinary tract infections in the elderly . Bull NY Acad Med 1980;;56:209-220.
10 +
Nordenstam GR, Brandberg CA, Oden AS, et al:  Bacteriuria and mortality in an elderly population . N Engl J Med 1986;;314:1152-1156.
11 +
Sourander LB, Kasanen A:  A five-year follow-up of bacteriuria in the aged . Gerontol Clin 1972;; 14:274-281.
12 +
Dontas AS, Kasviki-Charvati P, Papanayiotou PC, et al:  Bacteriuria and survival in old age . N Engl J Med 1981;;304:939-943.
13 +
Evans DA, Kass EH, Hennekens CH, et al:  Bacteriuria and subsequent mortality in women . Lancet 1982;;1:156-158.
14 +
Alling B, Brandberg A, Seeberg S, et al:  Effect of consecutive antibacterial therapy on bacteriuria in hospitalized geriatric patients . Scand J Infect Dis 1975;;7:201-207.
15 +
Brocklehurst JC, Bee P, Jones D, et al:  Bacteriuria in geriatric hospital patients, its correlates and management . Age Ageing 1977;;6:240-245.
16 +
Lacey RW, Simpson MHC, Lord VL, et al:  Comparison of single-dose trimethoprim with a five-day course for the treatment of urinary tract infections in the elderly . Age Ageing 1981;;10:179-185.
17 +
Nicolle LE, Bjornson J, Harding GKM, et al:  Bacteriuria in elderly institutionalized men . N Engl J Med 1983;;309:1420-1425.
18 +
Renneberg J, Paerregaard A:  Single-day treatment with trimethoprim for asymptomatic bacteriuria in the elderly patient . J Urol 1984;;132:934-935.
19 +
Sourander LB, Ruikka I, Gronroos M:  Correlation between urinary tract infection, prolapse conditions, and function of the bladder in aged female hospital patients . Gerontol Clin 1965;;7:179-184.
20 +
Lennette EH, Balows A, Hausler WJ Jr, et al (eds): Manual of Clinical Microbiology , ed 4. Washington, DC, American Society for Microbiology, 1985;, pp 143-411.
21 +
Jones RN, Barry AL, Gavan TL, et al (eds): Performance Standards for Antimicrobial Disc Susceptibility Tests , ed 3. Villanova, Pa, National Committee for Clinical Laboratory Standards, 1984;, vol 4, pp 369-383.
22 +
Pontzer RE, Krieger RE, Boscia JA, et al:  Single-dose cefonicid therapy for urinary tract infections . Antimicrob Agents Chemother 1983;;23: 814-816.
23 +
Greenberg RN, Sanders CV, Lewis AC, et al:  Single-dose cefaclor therapy of urinary tract infection . Am J Med 1981;;71:841-845.
24 +
Fang STL, Tblkoff-Rubin NE, Rubin RH:  Efficacy of single-dose and conventional amoxicillin therapy in urinary tract infection localized by the antibody-coated bacteria technique . N Engl J Med 1978;;298:413-416.
25 +
Rubin RH, Fang LST, Jones SR, et al:  Single-dose amoxicillin therapy for urinary tract infection . JAMA 1980;;244:561-564.
26 +
Schultz HJ, McCaffrey LA, Keys TI, et al:  Acute cystitis: A prospective study of laboratory tests and duration of therapy . Mayo Clin Proc 1984;;59:391-397.
27 +
Greenberg RN, Reilly PM, Luppen KL, et al:  Randomized study of single-dose, three-day, and seven-day treatment of cystitis in women . J Infect Dis 1986;;153:277-282.
28 +
Asscher AW, Sussman M, Waters WE, et al:  Asymptomatic significant bacteriuria in the non-pregnant woman: II. Response to treatment and follow-up . Br Med J 1969;;1:804-806.
29 +
Kass EH:  Bacteriuria and excess mortality: What should the next steps be ? Rev Infect Dis 1985;;7:S762-S766.

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Sourander LB:  Urinary tract infection in the aged: An epidemiological study . Ann Med Intern Fenn 1966;;55( (suppl 45) ):7-55.
2 +
Brocklehurst JC, Dillane JB, Griffiths L, et al:  The prevalence and symptomatology of urinary infection in an aged population . Gerontol Clin 1968;;10:242-253.
3 +
Akhtar AJ, Andrews GR, Caird FI, et al:  Urinary tract infection in the elderly: A population study . Age Ageing 1972;;1:48-54.
4 +
Kasviki-Charvati P, Drolette-Kefakis B, Papanayiotou PC, et al:  Turnover of bacteriuria in old age . Age Ageing 1982;;11:169-174.
5 +
Boscia JA, Kobasa WD, Knight RA, et al:  Epidemiology of bacteriuria in an elderly population . Am J Med 1986;;80:208-214.
6 +
Wolfson SA, Kalmanson GM, Rubini ME, et al:  Epidemiology of bacteriuria in a predominantly geriatric male population . Am J Med Sci 1965;;250: 168-173.
7 +
Klarskov P:  Bacteriuria in elderly women . Dan Med Bull 1976;;23:200-204.
8 +
Boscia JA, Kobasa WD, Abrutyn E, et al:  Lack of association between bacteriuria and symptoms in the elderly . Am J Med 1986;;81:979-982.
9 +
Kaye D:  Urinary tract infections in the elderly . Bull NY Acad Med 1980;;56:209-220.
10 +
Nordenstam GR, Brandberg CA, Oden AS, et al:  Bacteriuria and mortality in an elderly population . N Engl J Med 1986;;314:1152-1156.
11 +
Sourander LB, Kasanen A:  A five-year follow-up of bacteriuria in the aged . Gerontol Clin 1972;; 14:274-281.
12 +
Dontas AS, Kasviki-Charvati P, Papanayiotou PC, et al:  Bacteriuria and survival in old age . N Engl J Med 1981;;304:939-943.
13 +
Evans DA, Kass EH, Hennekens CH, et al:  Bacteriuria and subsequent mortality in women . Lancet 1982;;1:156-158.
14 +
Alling B, Brandberg A, Seeberg S, et al:  Effect of consecutive antibacterial therapy on bacteriuria in hospitalized geriatric patients . Scand J Infect Dis 1975;;7:201-207.
15 +
Brocklehurst JC, Bee P, Jones D, et al:  Bacteriuria in geriatric hospital patients, its correlates and management . Age Ageing 1977;;6:240-245.
16 +
Lacey RW, Simpson MHC, Lord VL, et al:  Comparison of single-dose trimethoprim with a five-day course for the treatment of urinary tract infections in the elderly . Age Ageing 1981;;10:179-185.
17 +
Nicolle LE, Bjornson J, Harding GKM, et al:  Bacteriuria in elderly institutionalized men . N Engl J Med 1983;;309:1420-1425.
18 +
Renneberg J, Paerregaard A:  Single-day treatment with trimethoprim for asymptomatic bacteriuria in the elderly patient . J Urol 1984;;132:934-935.
19 +
Sourander LB, Ruikka I, Gronroos M:  Correlation between urinary tract infection, prolapse conditions, and function of the bladder in aged female hospital patients . Gerontol Clin 1965;;7:179-184.
20 +
Lennette EH, Balows A, Hausler WJ Jr, et al (eds): Manual of Clinical Microbiology , ed 4. Washington, DC, American Society for Microbiology, 1985;, pp 143-411.
21 +
Jones RN, Barry AL, Gavan TL, et al (eds): Performance Standards for Antimicrobial Disc Susceptibility Tests , ed 3. Villanova, Pa, National Committee for Clinical Laboratory Standards, 1984;, vol 4, pp 369-383.
22 +
Pontzer RE, Krieger RE, Boscia JA, et al:  Single-dose cefonicid therapy for urinary tract infections . Antimicrob Agents Chemother 1983;;23: 814-816.
23 +
Greenberg RN, Sanders CV, Lewis AC, et al:  Single-dose cefaclor therapy of urinary tract infection . Am J Med 1981;;71:841-845.
24 +
Fang STL, Tblkoff-Rubin NE, Rubin RH:  Efficacy of single-dose and conventional amoxicillin therapy in urinary tract infection localized by the antibody-coated bacteria technique . N Engl J Med 1978;;298:413-416.
25 +
Rubin RH, Fang LST, Jones SR, et al:  Single-dose amoxicillin therapy for urinary tract infection . JAMA 1980;;244:561-564.
26 +
Schultz HJ, McCaffrey LA, Keys TI, et al:  Acute cystitis: A prospective study of laboratory tests and duration of therapy . Mayo Clin Proc 1984;;59:391-397.
27 +
Greenberg RN, Reilly PM, Luppen KL, et al:  Randomized study of single-dose, three-day, and seven-day treatment of cystitis in women . J Infect Dis 1986;;153:277-282.
28 +
Asscher AW, Sussman M, Waters WE, et al:  Asymptomatic significant bacteriuria in the non-pregnant woman: II. Response to treatment and follow-up . Br Med J 1969;;1:804-806.
29 +
Kass EH:  Bacteriuria and excess mortality: What should the next steps be ? Rev Infect Dis 1985;;7:S762-S766.

Letters

Submit a Letter
CME Course for:


You need to register in order to view this quiz.


To understand the clinical management of acute heart failure syndromes.
Accreditation Information The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
To view and print your certificate and access a summary of your CME courses go to My CME.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Compression-Only CPR: Pushing the Science Forward
Cone
AAM 2010;304:1493-1495.
All you need to read in the other general journals
BMJ 2010;341:c5893-c1494.
Submit a Comment

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

© 2012 American Medical Association. All Rights Reserved.
Powered bySilverchair Information Systems