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Researchers instruct doctors to avoid regular urinary tract examinations in older patients with delirium

Based on a new study, researchers at Johns Hopkins Medicine recommend that doctors avoid regular and unnecessary urinalysis in elderly patients with delirium in the absence of clinical signs or symptoms of infection.Credits: ME Newman, Johns Hopkins Medicine, using public domain images

Based on the results of new high-value health care studies, Johns Hopkins medical researchers recommend that doctors avoid regular urinalysis in elderly patients with delirium in the absence of clinical signs or symptoms of infection. doing.

“Just because it’s an easy test doesn’t mean it’s a good test,” said Dr. Milad Memari, MD, a research intern at Johns Hopkins University School of Medicine. “Our study shows that older, capricious, and incapable of showing a medical history are more likely to suffer from unnecessary test and treatment results. Urinalysis is more common. If so, this is one of the first things doctors want in these situations. “

This study was conducted on July 26, 2021 Hospital medicine journal..

In their study, Memari and his colleagues reviewed previous studies by other researchers who evaluated the performance of urinalysis in hospitals, especially in the elderly with delirium.from One of these studies, Memari’s team found that 83% of approximately 3,000 patients in hospitals nationwide, including patients over the age of 65, received antibiotic therapy based on a bacterial-positive urine culture. Microorganisms It may actually be harmless.According to another survey, more than a quarter (92 out of 343 patients, or 27%) Antibiotics When they had no clinical signs of urinary tract infection and were suffering from the detrimental long-term consequences of these treatments that may have been unnecessary.

“Elderly patients with dementia report symptoms such as pain, burning sensation when urinating, frequent urination, lower abdominal pain, or clinically such as fever, hypotension, increased heart rate, increased leukocyte count. If you have symptoms, a urine test may be appropriate, “says Memari. “In the absence of symptoms consistent with infection or clinical symptoms, doctors should refrain from urinalysis to avoid complications from unnecessary antibiotic treatment, resulting in longer hospital stays and slower recovery times. , The outcome will be worse. “

Memari adds that many older patients grow bacteria in urine cultures, but they may not actually have a urinary tract infection.He says the focus should be on avoiding unnecessary tests to prevent treatment Bacteria This is the normal and healthy part of the patient’s urinary system. Also, the more patients are treated for urinary tract infections, the more likely they are to develop resistance to antibiotics.

Second, Memari says this makes it difficult to treat urinary tract infections in future cases and contributes to the public health problem of increased antibiotic resistance in highly vulnerable populations.

“When treating the elderly, we must first remember the principle of“ harmless ”,” says Memari. “Our team has performed unnecessary urinalysis to prevent this review of existing studies from causing long-term harm to elderly patients with delirium and to provide more accurate and personalized care. I hope to start a conversation at hospitals across the country about restraint. ”


Unnecessary testing of UTIs has been reduced by almost half


For more information:
Hospital medicine journal (2021). DOI: 10.12788 / jhm.3620 , www.journalofhospitalmedicine. …-Older? channel = 27621

Quote: The researcher was an elderly patient with delirium (July 2021) obtained from https://medicalxpress.com/news/2021-07-doctors-routine-urinary-older-patients.html on July 29, 2021. Instruct your doctor to avoid regular urinalysis (29th)

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Researchers instruct doctors to avoid regular urinary tract examinations in older patients with delirium

Source link Researchers instruct doctors to avoid regular urinary tract examinations in older patients with delirium

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