A 86-year-old woman with advanced dementia in a care home has recurrent urinary tract infections (four episodes in 12 months). She has a long-term uri...

Question

A 86-year-old woman with advanced dementia in a care home has recurrent urinary tract infections (four episodes in 12 months). She has a long-term urinary catheter in situ. Her urine frequently tests positive for leucocytes and nitrites on dipstick. She is asymptomatic. The care home staff want to treat with antibiotics. What is the MOST appropriate advice?

Accepted Answer

Do not treat asymptomatic bacteriuria - positive urine dipstick in a catheterised patient does not indicate infection requiring treatment unless there are systemic signs of infection

Answer

Prescribe prophylactic antibiotics indefinitely

Answer

Prescribe Nitrofurantoin 50 mg at night as prophylaxis

Answer

Remove the catheter and arrange for intermittent self-catheterisation

Answer

Prescribe a 14-day course of Co-amoxiclav

uk-dgm MCQ (SBA): Asymptomatic Bacteriuria in Catheterised Patients