Urinary Tract Infection in Women Over the Age of 65: Is Age Alone a Marker of Complication?

Background: We were interested to know if our older female patients with urinary tract infections (UTIs) might have differing pathogens or rates of Escherichia coli antibiotic sensitivity and if our physi-cians managed them in a manner similar or dissimilar to the care provided to younger patients with no complications. Methods: This was a secondary analysis from patients excluded from a previous retrospective study regarding uncomplicated UTIs. Results: Twenty-six percent of total patients with UTIs were older than 65 and otherwise medically uncomplicated whereas 21 % were older patients who did have complicating factors. E. coli was a patho-gen in 81 % of uncomplicated elders ’ and 54 % of complicated elders ’ cultures. E. coli sensitivity rate to sulfamethoxazole-trimethoprim (SMX/TMP) in both groups was 86%. Physicians were significantly less likely to prescribe SMX/TMP for complicated older patients with complications than for young patients with an uncomplicated UTI (P .017); there was a significant trend of physicians to be less likely to prescribe SMX/TMP with advancing age in a patient and complications across all 3 groups (P .011). Antibiotics rarely needed to be changed after cultures. Conclusions: The presence of E. coli on culture in patients with a UTI changes based on medica