A 79-year-old woman in a residential aged care facility is increasingly confused. Staff report foul-smelling urine but she has no dysuria, frequency, ...

Question

A 79-year-old woman in a residential aged care facility is increasingly confused. Staff report foul-smelling urine but she has no dysuria, frequency, fever or flank pain. Urinalysis shows leukocytes and nitrites. According to Choosing Wisely and RACGP guidance, what is the best management?

Accepted Answer

Avoid antibiotics unless she develops localising urinary or systemic symptoms

Answer

Start antibiotics immediately for presumed UTI

Answer

Treat only if urine culture is positive for >10^5 CFU/mL

Answer

Start prophylactic daily antibiotics

Answer

Send urine for cytology

au-amc MCQ (SBA): Asymptomatic bacteriuria in the elderly

A 79-year-old woman in a residential aged care facility is increasingly confused. Staff report foul-smelling urine but she has no dysuria, frequency, fever or flank pain. Urinalysis shows leukocytes and nitrites. According to Choosing Wisely and RACGP guidance, what is the best management?