Alternative to antibiotics for managing asymptomatic and non-symptomatic bacteriuria in older persons: a review

Br J Community Nurs. 2019 Mar 2;24(3):116-119. doi: 10.12968/bjcn.2019.24.3.116.


Recurrent urinary tract infection (UTI) is one of the most common reasons for long-term antibiotic use in frail older people, and these individuals often have non-symptomatic bacteriuria. This article reviews the literature and recommendations for the treatment of UTIs particularly in the older population (>65 years). It considers the question: is there an alternative for antibiotics for asymptomatic and non-symptomatic bacteriuria in older adults? D-mannose powder has been recommended for the treatment of UTIs, as when applied locally, it reduces the adherence of Escherichia coli. In one study, D-mannose was reviewed for the prophylaxis of recurrent UTIs in women, and the findings indicated that it may be useful for UTI prevention instead of prophylactic antibiotics. There is a lack of information about the efficacy of cranberry products combined with D-mannose in this regard, and this is an area for further research.

Keywords: Antibiotic prophylaxis; Asymptomatic and non-symptomatic bacteriuria; Older adults; Recurrent urinary tract infection.

Publication types

  • Review

MeSH terms

  • Aged
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / therapeutic use
  • Community Health Nursing
  • Frail Elderly*
  • Humans
  • Hygiene*
  • Practice Patterns, Nurses'*
  • Urinary Tract Infections / nursing
  • Urinary Tract Infections / therapy*


  • Anti-Bacterial Agents