TY - JOUR
T1 - Diagnosis, Treatment, and Prevention of Urinary Tract Infections in Post-Acute and Long-Term Care Settings
T2 - A Consensus Statement From AMDA's Infection Advisory Subcommittee
AU - Infection Advisory SubCommittee for AMDA—The Society of Post-Acute and Long-Term Care Medicine
AU - Ashraf, Muhammad S.
AU - Gaur, Swati
AU - Bushen, Oluma Y.
AU - Chopra, Teena
AU - Chung, Philip
AU - Clifford, Kalin
AU - Hames, Elizabeth
AU - Hertogh, Cees M.P.M.
AU - Krishna, Amar
AU - Mahajan, Dheeraj
AU - Mehr, David R.
AU - Nalls, Vycki
AU - Rowe, Theresa Ann
AU - Schweon, Steven J.
AU - Sloane, Philip D.
AU - Trivedi, Kavita K.
AU - van Buul, Laura W.
AU - Jump, Robin L.P.
N1 - Funding Information:
This work was supported in part by funds and facilities provided by the Cleveland Department of Veterans Affairs (VA), the Cleveland Geriatric Research Education and Clinical Center (GRECC) and the Specialty Care Center of Innovation. Additional support was provided by the VA Merit Review Program (PPO 16-118-1; RJ). The findings and conclusions in this document are those of the authors, who are responsible for its content, and do not necessarily represent the views of the VA or of the United States Government.None of the authors have relevant conflicts of interest to disclose. M.S.A. is the Principal Investigator on an investigator initiated research grant funded by Merck & Co Inc. R.L.P.J is the Principal Investigator on research grants from Pfizer and Accelerate; she has also participated in advisory boards for Pfizer and Merck. S.J.S is a consultant for Crothall Healthcare, TouchPoint, and Morrison and has also worked for APIC consulting.
PY - 2020/1
Y1 - 2020/1
N2 - The diagnosis and management of urinary tract infections (UTIs) among residents of post-acute and long-term care (PALTC) settings remains challenging. Nonspecific symptoms, complex medical conditions, insufficient awareness of diagnostic criteria, and unnecessary urine studies all contribute to the inappropriate diagnosis and treatment of UTIs in PALTC residents. In 2017, the Infection Advisory Subcommittee at AMDA—The Society for Post-Acute and Long-Term Care Medicine convened a workgroup comprised of experts in geriatrics and infectious diseases to review recent literature regarding UTIs in the PALTC population. The workgroup used evidence as well as their collective clinical expertise to develop this consensus statement with the goal of providing comprehensive guidance on the diagnosis, treatment, and prevention of UTIs in PALTC residents. The recommendations acknowledge limitations inherent to providing medical care for frail older adults, practicing within a resource limited setting, and prevention strategies tailored to PALTC populations. In addition, the consensus statement encourages integrating antibiotic stewardship principles into the policies and procedures used by PALTC nursing staff and by prescribing clinicians as they care for residents with a suspected UTI.
AB - The diagnosis and management of urinary tract infections (UTIs) among residents of post-acute and long-term care (PALTC) settings remains challenging. Nonspecific symptoms, complex medical conditions, insufficient awareness of diagnostic criteria, and unnecessary urine studies all contribute to the inappropriate diagnosis and treatment of UTIs in PALTC residents. In 2017, the Infection Advisory Subcommittee at AMDA—The Society for Post-Acute and Long-Term Care Medicine convened a workgroup comprised of experts in geriatrics and infectious diseases to review recent literature regarding UTIs in the PALTC population. The workgroup used evidence as well as their collective clinical expertise to develop this consensus statement with the goal of providing comprehensive guidance on the diagnosis, treatment, and prevention of UTIs in PALTC residents. The recommendations acknowledge limitations inherent to providing medical care for frail older adults, practicing within a resource limited setting, and prevention strategies tailored to PALTC populations. In addition, the consensus statement encourages integrating antibiotic stewardship principles into the policies and procedures used by PALTC nursing staff and by prescribing clinicians as they care for residents with a suspected UTI.
KW - Urinary tract infection
KW - antimicrobial stewardship
KW - infection prevention and control
KW - nursing homes
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U2 - 10.1016/j.jamda.2019.11.004
DO - 10.1016/j.jamda.2019.11.004
M3 - Article
C2 - 31888862
AN - SCOPUS:85076893877
VL - 21
SP - 12-24.e2
JO - Journal of the American Medical Directors Association
JF - Journal of the American Medical Directors Association
SN - 1525-8610
IS - 1
ER -