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JAC Advance Access published online on November 19, 2008
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkn458
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© The Author 2008. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Leading article

Urinary tract infection in hospitalized elderly patients in the United Kingdom: the importance of making an accurate diagnosis in the post broad-spectrum antibiotic era

G. Gopal Rao1,* and Mehool Patel2

1 Department of Microbiology, University Hospital Lewisham, London, UK 2 Care of the Elderly Medicine, University Hospital Lewisham, London, UK

* Corresponding author. Present address: Department of Microbiology, Northwick Park Hospital, Watford Road, Harrow, Middlesex HA1 3UJ, UK. E-mail: guduru.gopalrao{at}nwlh.nhs.uk

The increasing prevalence of Clostridium difficile infection (CDI) has prompted many hospitals in the UK to recommend the use of narrow-spectrum antibiotics targeted at the likely bacteria at the clinical site of infection instead of broad-spectrum antibiotics. An underpinning requirement of such a strategy is the need to make an accurate diagnosis. In elderly patients, diagnosis of urinary tract infection can be challenging due to the frequent presence of respiratory signs and difficulties in the collection of urine specimens. This leads to the use of broad-spectrum antibiotics. Clinicians should attempt to make an accurate diagnosis of respiratory and urinary infections, as this will be crucial in the choice of the appropriate narrow-spectrum antibiotics.

Key Words: UTIs , antibiotics , C. difficile , CDI


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