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In ambulatory care settings, older women frequently are diagnosed with urinary tract infections (UTIs) on the basis of nonspecific symptoms (e.g., mental status changes, malaise) and abnormal urinalysis. Because urine culture results aren't available for several days, many patients whose cultures ultimately are negative receive antibiotics.
In this retrospective study from an emergency department in Rhode Island, researchers identified 153 women (age, ≥70; mean age, 83) who received UTI diagnoses and for whom urine cultures were ordered. Urine was obtained by clean catch in 58% and by catheterization in 42%. Urinary symptoms were the chief complaint in only 18%; other complaints included altered mental status (18%), abdominal or back pain (1…