Antibiotic treatment and resistance of unselected uropathogens in the elderly

A population-based study was conducted among women over the age of 70 years with complaints of uncomplicated urinary tract infections (UTIs). The positive predictive value of the nitrite test alone or in combination with the leukocyte esterase test ranged between 83% and 99%. The nitrofurantoin prescription rate decreased whereas fluoroquinolone and amoxicillin/clavulanic acid prescriptions increased with increasing age. The aetiology of infection was age-dependent. Escherichia coli was the most commonly isolated uropathogen, followed by Proteus mirabilis and Klebsiella pneumoniae. For these uropathogens, the lowest susceptibility percentages were found for amoxicillin, trimethoprim and co-trimoxazole. As trimethoprim susceptibility reached ∼75%, it may be advisable not to use this as a first-choice agent in the treatment of uncomplicated UTIs in the elderly.