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Urinary Tract Infections and the Dangers of Overtreating the Elderly

One size does not fit all in medicine. Yet far too often, health care providers do not consider something as basic as age when performing tests or delivering treatment. This can result in serious adverse affects for elderly men and women and be a form of medical malpractice.

One example of this phenomenon is the overtreatment of urinary tract infections (UTIs) in the elderly. The Archives of Internal Medicine recently published a study on care of these patients. The study documented numerous grounds for concern, including medication errors and overtreatment.

Researchers led by Dr. David Dosa, a geriatrician at Brown University, reviewed the medical records of 172 residents of two Rhode Island nursing homes who had been diagnosed with UTIs. The team discovered that in many cases, physicians prescribed broad-spectrum antibiotics to these elderly patients based solely on a positive urinalysis. The study revealed improper dosing and other treatment errors that led to other and often more serious risks.

Dosa's team discovered that patients treated with broad-spectrum antibiotics, even though diagnostic protocols did not call for these drugs, were more like to suffer from more virulent infections, such as those associated with Clostridium difficile - C. difficile - bacteria. These bacteria flourish in the intestines when other competing bacteria are eliminated by drug therapies. Symptoms of C. difficile infections range from nausea and vomiting to life-threatening inflammation of the colon.

C. difficile infections are not the only risks. Depending on the antibiotic course and the strength of the doses, patients could suffer from cardiac and respiratory issues, gastrointestinal complications, sensory disturbances and neurological side effects.

UTIs are common ailments among the elderly. Ranging from cystitis to bacteruria to pyuria, these infections in seniors pose real challenges to treating physicians. However, medical professionals need to take special care not to overtreat these patients.

Medical care providers should realize that geriatric patients are different in important respects from younger patients. Older people are more susceptible to risks associated with various tests and treatments. Failure to recognize that fact can harm older patients and constitute medical malpractice.

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