Management of urinary tract infections in elderly at the Rehabilitation Hospital Karin Grech

Abstract

OBJECTIVE: To assess the percentage of patients suffering from urinary tract infections (UTIs) who were treated at the Rehabilitation Hospital Karin Grech (RHKG) and to evaluate treatment choices used to manage UTIs at the same hospital during a one-year period. METHOD: A retrospective and current study were carried out to collect information about patients who were diagnosed with UTIs namely age, gender, medical history, medications and presence of a catheter. This information was obtained from patient profiles in each of a total of 9 wards in the hospital. Analysis of data was carried out using Microsoft office Excel® 2010 and SPSS® version 20. KEY FINDINGS: Out of 165 UTI patients, 67% were female (n=111) and 33% were male (n=54). Thirty-seven percent of the patients were diabetic. Ninety patients had a catheter prior to the period of infection and an association between catheterisation and type and number of UTI pathogens was reported. Presence of a catheter increased the chance of being affected by two or three different types of UTI pathogens which are more resistant than pathogens which were contracted by non-catheterised UTI patients in one episode. The majority of UTI cases at RHKG were treated with nitrofurantoin (41.8%), the first line agent as mentioned in hospital guidelines, followed by ciprofloxacin and co-amoxiclav at 27.3% and 20.0% respectively. Out of the 41.8% of patients who were treated with nitrofurantoin, 30.4% had an estimated glomerular filtration rate (eGF R) and/or urinary pH unsuitable for nitrofurantoin use. CONCLUSION: A prevalence of UTIs in hospitalised patients at RHKG of 11% was identified. Catheterisation increased risk of UTI and presented with a higher number of different pathogens. Nitrofurantoin was the main antibacterial used in the management of UTIs.