Urinary Tract Infection and Asymptomatic Bacteriuria in Older Adults

Infect Dis Clin North Am. 2017 Dec;31(4):673-688. doi: 10.1016/j.idc.2017.07.002.


Urinary tract infections (UTIs) are a significant cause of morbidity among older adults. However, antibiotic prescriptions for clinically suspected UTIs are often inappropriate. Health care providers frequently struggle to differentiate UTI from asymptomatic bacteriuria, particularly in patients presenting with nonspecific symptoms. Patients with baseline cognitive impairments that limit history-taking can be particularly challenging. This article reviews the epidemiology and pathogenesis of UTI in older adults. It discusses an approach to diagnosis and treatment focused on recognizing patients who would likely benefit from antibiotic treatment and on identifying patients for whom empiric antibiotic therapy should not be given.

Keywords: Asymptomatic bacteriuria; Older adults; Urinary tract infection.

Publication types

  • Review

MeSH terms

  • Aged
  • Aging
  • Anti-Bacterial Agents / therapeutic use
  • Bacterial Infections / diagnosis
  • Bacterial Infections / drug therapy
  • Bacterial Infections / microbiology*
  • Bacteriuria / diagnosis*
  • Bacteriuria / microbiology*
  • Humans
  • Urinary Tract Infections / microbiology*


  • Anti-Bacterial Agents