Llor Carl, Olsen Jonas, Lykkegaard Jesper, Anastasaki Marilena, Nygaard Jensen Jette, Søndergaard Jens, Antsupova Valeria, Petek Davorina, Hansen Malene Plejdrup, Theut Marie, Lions Christos, Jaruseviciene Lina, Radzeviciene Ruta, Bálint András, Glasova Helena, Glasa Jozef, Sodja Nina, Moragas Ana, Monfà Ramon, García-Sangenís Ana, Kowalczyk Anna, Ruppe Georg, Vallejo-Torres Laura, Elistratova Marina, González López-Valcárcel Beatriz, Tsoulchai Greta
Primary Care Research Institute Jordi Gol (IDIAP), Barcelona, Spain.
CIBER Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain.
Expert Rev Anti Infect Ther. 2025 Feb-Apr;23(2-4):235-241. doi: 10.1080/14787210.2025.2456860. Epub 2025 Jan 26.
Nursing home (NH) residents are frequently treated with antibiotics for urinary tract infections (UTIs), often due to overdiagnosis. The aim of this study was to evaluate the proportion of potentially unnecessary antibiotic use for suspected UTIs in NHs across eight European countries.
Over a three-month period (February to April 2024), NH professionals recorded information on all antibiotic treatments for UTIs using a specific registration chart. Based on medical literature and the expertise of the project consortium members, the authors developed and endorsed by consensus a simplified algorithm to assess unnecessary antibiotic use in residents without indwelling catheters.
The study, conducted across 110 NHs, included 2773 antibiotic-treated infections. Of these, 1158 (41.8%) were treated for UTIs. Among 975 UTI cases without catheters, 54.1% may have been unnecessarily treated. Over one-third involved nonspecific symptoms including poor general condition and changes in urine appearance, while specific urinary symptoms, such as incontinence (21.3%) and dysuria (20.8%), were less common. A trend toward greater, potentially unnecessary antibiotic use was observed when urine dipsticks were performed.
The findings reveal potentially unnecessary antibiotic use. Further algorithm validation is needed to enhance diagnostic criteria, reduce overuse, and improve UTI management in NHs.
养老院居民经常因尿路感染（UTI）接受抗生素治疗，这通常是由于过度诊断所致。本研究的目的是评估八个欧洲国家养老院中疑似尿路感染患者潜在不必要抗生素使用的比例。
在三个月期间（2024年2月至4月），养老院专业人员使用特定的登记图表记录了所有尿路感染抗生素治疗的信息。基于医学文献和项目联盟成员的专业知识，作者制定并经共识认可了一种简化算法，以评估无留置导尿管居民中不必要的抗生素使用情况。
该研究在110家养老院进行，包括2773例接受抗生素治疗的感染病例。其中，1158例（41.8%）因尿路感染接受治疗。在975例无导尿管的尿路感染病例中，54.1%可能接受了不必要的治疗。超过三分之一的病例涉及非特异性症状，包括一般状况不佳和尿液外观改变，而特定的泌尿系统症状，如尿失禁（21.3%）和排尿困难（20.8%）则较少见。进行尿试纸检测时，观察到潜在不必要抗生素使用增加的趋势。
研究结果揭示了潜在不必要的抗生素使用情况。需要进一步验证算法，以完善诊断标准、减少过度使用并改善养老院尿路感染的管理。
