Antibiotics are medicines that can kill bacteria. Doctors often use antibiotics to treat urinary tract infections (UTIs). However, many older people get UTI treatment even though they do not have these symptoms. This can do more harm than good.

• Antibiotics usually don’t help when there are no UTI symptoms. Older people often have some bacteria in their urine. This does not mean they have a UTI. Most older people should not be tested or treated for a UTI unless they have UTI symptoms. You should only get tested or treated if UTI symptoms come back.
• Antibiotics have side effects. Antibiotics can have side effects, such as fever, rash, diarrhea, nausea, vomiting, headache, tendon ruptures, and nerve damage.
• Antibiotics can cause future problems. Antibiotics can kill “friendly” germs in the body. This can lead to vaginal yeast infections. It can also lead to other infections, and severe diarrhea, hospitalization, and even death. Also, antibiotics may help “drug resistant” bacteria grow.

When should older people take antibiotics for a UTI?

If you have UTI symptoms, antibiotics can help.

• The most common UTI symptoms are a painful, burning feeling when you urinate and a strong urge to “go” often.
• Other UTI symptoms in older people may include fever, chills, or confusion. Along with these symptoms, there is usually pain on one side of the back below the ribs or discomfort in the lower abdomen. There may be a change in the way the urine looks or smells.
• Some kinds of surgery can cause bleeding in the urinary tract—for example, prostate surgery and some procedures to remove kidney stones or bladder tumors. If you are going to have this surgery, you may need testing and treatment for bacteria in urine.

Steps to help you prevent urinary tract infections (UTIs)

• Drink water. Most healthy people should drink six to eight glasses a day. A glass is about a cup or about 250 mL. If you have kidney failure, you should talk to your doctor about how much to drink.
• Don’t hold it in. If urine stays in the bladder too long, infections are more likely. Try to urinate when you first feel the need.
• Use good hygiene. After a bowel movement, women should wipe from front to back, to avoid bringing bacteria into the urinary tract. Both men and women should urinate after sex to flush out bacteria.
• Use urinary catheters briefly, if at all.

Conditions: Bacteriuria, Urinary Tract Infection (UTI)

Diagnostic Tests: Urine Analysis (UA)

Treatments: Antimicrobial Treatment (Antibiotics)