• Ned Tijdschr Geneeskd · Aug 2019

    [Are we too economical with antibiotics in elderly patients?]

    • ZwartDorien L MDLMUMC Utrecht, Julius Centrum voor Gezondheidswetenschappen en Eerstelijns Geneeskunde, Utrecht.Contact: D.L.M. Zwart (d.zwart@umcutrecht.nl)..
    • UMC Utrecht, Julius Centrum voor Gezondheidswetenschappen en Eerstelijns Geneeskunde, Utrecht.
    • Ned Tijdschr Geneeskd. 2019 Aug 19; 163.

    AbstractA large population-based cohort study by Gharbi et al. found an association between deferred or no antibiotic prescribing in patients with a urinary tract infection (UTI) or suspected UTI and an increased incidence of bloodstream infections and all-cause mortality. The study concludes that early initiation of antibiotics in (high risk) elderly is recommended. This contradicts with recently adjusted guidelines for UTI infections in elderly, in which clinicians are encouraged to be prudent with the prescription of antibiotics in order to avoid over-treatment. Critical appraisal of the study, however, reveals several arguments that challenge the clinical relevance of the findings; a nuanced interpretation of this study's conclusion is therefore indicated. Altogether, current guidelines for elderly with UTI provide sufficient standards for safe care, since they emphasize that holding back antibiotics should be combined with a careful watchful waiting policy and adequate safety net advice.

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