{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T00:03:13Z","timestamp":1775520193176,"version":"3.50.1"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,11,29]],"date-time":"2022-11-29T00:00:00Z","timestamp":1669680000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,11,29]],"date-time":"2022-11-29T00:00:00Z","timestamp":1669680000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Geriatr"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Among older adults with delirium and positive urinalysis, antibiotic treatment for urinary tract infection is common practice, but unsupported by literature or guidelines. We sought to: i) determine the rate of antibiotic treatment and\u00a0the proportion of asymptomatic patients (other than delirium) in this patient population, and ii) examine the effect of antibiotic treatment on delirium resolution and adverse outcomes.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A health record review was conducted at a tertiary academic centre from January to December 2020. Inclusion criteria were age\u2009\u2265\u200965, positive delirium screening assessment, positive urinalysis, and admission to general medical units. Outcomes included rates of antibiotic treatment, delirium on day 7 of admission, and 30-day adverse outcomes. We compared delirium and adverse outcome rates in antibiotic-treated vs. non-treated groups. We conducted subgroup analyses among asymptomatic patients.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>We included 150 patients (57% female, mean age 85.4\u2009years). Antibiotics were given to 86%. The asymptomatic subgroup (delirium without urinary symptoms or fever) comprised 38% and antibiotic treatment rate in this subgroup was 68%. There was no significant difference in delirium rate on day 7 between antibiotic-treated vs. non-treated groups, (entire cohort RR 0.94 [0.41\u20132.16] and asymptomatic subgroup RR 0.69 [0.22\u20132.15]) or in 30-day adverse outcomes.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Older adults with delirium and positive urinalysis in general medical inpatient units were frequently treated with antibiotics \u2013 often despite the absence of urinary or other infectious symptoms. We failed to find evidence that antibiotic treatment in this population is associated with delirium resolution on day 7 of admission.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12877-022-03549-8","type":"journal-article","created":{"date-parts":[[2022,11,29]],"date-time":"2022-11-29T12:08:20Z","timestamp":1669723700000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Effect of inpatient antibiotic treatment among older adults with delirium found with a positive urinalysis: a health record review"],"prefix":"10.1186","volume":"22","author":[{"given":"Pil","family":"Joo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lars","family":"Grant","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tim","family":"Ramsay","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caroline","family":"Nott","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosemary","family":"Zvonar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason","family":"Jia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Krishan","family":"Yadav","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eisi","family":"Mollanji","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"He","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Debra","family":"Eagles","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,11,29]]},"reference":[{"issue":"8","key":"3549_CR1","first-page":"977","volume":"163","author":"M Elie","year":"2000","unstructured":"Elie M, Rousseau F, Cole M, Primeau F, McCusker J, Bellavance F. Prevalence and detection of delirium in elderly emergency department patients. CMAJ. 2000;163(8):977\u201381.","journal-title":"CMAJ"},{"issue":"9920","key":"3549_CR2","doi-asserted-by":"publisher","first-page":"911","DOI":"10.1016\/S0140-6736(13)60688-1","volume":"383","author":"SK Inouye","year":"2014","unstructured":"Inouye SK, Westendorp RG, Saczynski JS. Delirium in elderly people. Lancet. 2014;383(9920):911\u201322.","journal-title":"Lancet"},{"key":"3549_CR3","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1007\/s43678-021-00148-1","volume":"24","author":"A Lagu\u00eb","year":"2021","unstructured":"Lagu\u00eb A, Boucher V, Joo P, Yadav K, Morasse C, \u00c9mond M. Investigation and treatment of asymptomatic bacteriuria in older patients with delirium: a cross-sectional survey of Canadian physicians. CJEM. 2021;24:61\u20137.","journal-title":"CJEM"},{"issue":"1","key":"3549_CR4","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1186\/s12877-019-1049-7","volume":"19","author":"S Mayne","year":"2019","unstructured":"Mayne S, Bowden A, Sundvall P-D, Gunnarsson R. The scientific evidence for a potential link between confusion and urinary tract infection in the elderly is still confusing - a systematic literature review. BMC Geriatr. 2019;19(1):32.","journal-title":"BMC Geriatr"},{"issue":"4","key":"3549_CR5","doi-asserted-by":"publisher","first-page":"341","DOI":"10.5770\/cgj.24.518","volume":"24","author":"RAM Pinnell","year":"2021","unstructured":"Pinnell RAM, Ramsay T, Wang H, Joo P. Urinary tract infection investigation and treatment in older adults presenting to the emergency department with confusion: a health record review of local practice patterns. Can Geriatr J. 2021;24(4):341\u201350.","journal-title":"Can Geriatr J"},{"issue":"4","key":"3549_CR6","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1155\/2009\/702545","volume":"20","author":"SA Silver","year":"2009","unstructured":"Silver SA, Baillie L, Simor AE. Positive urine cultures: a major cause of inappropriate antimicrobial use in hospitals? Can J Infect Dis Med Microbiol. 2009;20(4):107\u201311.","journal-title":"Can J Infect Dis Med Microbiol"},{"issue":"1","key":"3549_CR7","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s13670-016-0157-x","volume":"5","author":"LE Nicolle","year":"2016","unstructured":"Nicolle LE. Asymptomatic bacteriuria in older adults. Curr Geri Rep. 2016;5(1):1\u20138.","journal-title":"Curr Geri Rep"},{"issue":"10","key":"3549_CR8","doi-asserted-by":"publisher","first-page":"e83","DOI":"10.1093\/cid\/ciz021","volume":"68","author":"LE Nicolle","year":"2019","unstructured":"Nicolle LE, Gupta K, Bradley SF, Colgan R, DeMuri GP, Drekonja D, et al. Clinical practice guideline for the Management of Asymptomatic Bacteriuria: 2019 update by the Infectious Diseases Society of America. Clin Infect Dis. 2019;68(10):e83\u2013e110.","journal-title":"Clin Infect Dis"},{"issue":"6","key":"3549_CR9","doi-asserted-by":"publisher","first-page":"963","DOI":"10.1111\/j.1532-5415.2009.02227.x","volume":"57","author":"M Juthani-Mehta","year":"2009","unstructured":"Juthani-Mehta M, Quagliarello V, Perrelli E, Towle V, Van Ness PH, Tinetti M. Clinical features to identify urinary tract infection in nursing home residents: a cohort study. J Am Geriatr Soc. 2009;57(6):963\u201370.","journal-title":"J Am Geriatr Soc"},{"issue":"1","key":"3549_CR10","doi-asserted-by":"publisher","first-page":"22","DOI":"10.5770\/cgj.17.90","volume":"17","author":"SA Balogun","year":"2014","unstructured":"Balogun SA, Philbrick JT. Delirium, a symptom of UTI in the elderly: fact or fable? A systematic review. Can Geriatr J. 2014;17(1):22\u20136.","journal-title":"Can Geriatr J"},{"issue":"11","key":"3549_CR11","doi-asserted-by":"publisher","first-page":"3312","DOI":"10.1111\/jgs.17418","volume":"69","author":"D Krinitski","year":"2021","unstructured":"Krinitski D, Kasina R, Kl\u00f6ppel S, Lenouvel E. Associations of delirium with urinary tract infections and asymptomatic bacteriuria in adults aged 65 and older: a systematic review and meta-analysis. J Am Geriatr Soc. 2021;69(11):3312\u201323.","journal-title":"J Am Geriatr Soc"},{"issue":"3","key":"3549_CR12","doi-asserted-by":"publisher","first-page":"484","DOI":"10.1111\/jgs.15679","volume":"67","author":"JM Caterino","year":"2019","unstructured":"Caterino JM, Kline DM, Leininger R, Southerland LT, Carpenter CR, Baugh CW, et al. Nonspecific symptoms lack diagnostic accuracy for infection in older patients in the emergency department. J Am Geriatr Soc. 2019;67(3):484\u201392.","journal-title":"J Am Geriatr Soc"},{"issue":"1","key":"3549_CR13","first-page":"4","volume":"3","author":"E Blondel-Hill","year":"2018","unstructured":"Blondel-Hill E, Patrick D, Nott C, Abbass K, Lau TTY, German G. AMMI Canada position statement on asymptomatic bacteriuria. Off J Assoc Med Microbiol Infect Dis Can. 2018;3(1):4\u20137.","journal-title":"Off J Assoc Med Microbiol Infect Dis Can"},{"issue":"12","key":"3549_CR14","doi-asserted-by":"publisher","first-page":"1495","DOI":"10.1016\/j.ijsu.2014.07.013","volume":"12","author":"E Von Elm","year":"2014","unstructured":"Von Elm E, Altman DG, Egger M, Pocock SJ, G\u00f8tzsche PC, Vandenbroucke JP, et al. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. Int J Surg. 2014;12(12):1495\u20139.","journal-title":"Int J Surg"},{"issue":"4","key":"3549_CR15","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1016\/j.amjmed.2013.10.016","volume":"127","author":"R McKenzie","year":"2014","unstructured":"McKenzie R, Stewart MT, Bellantoni MF, Finucane TE. Bacteriuria in individuals who become delirious. Am J Med. 2014;127(4):255\u20137.","journal-title":"Am J Med"},{"issue":"7","key":"3549_CR16","doi-asserted-by":"publisher","first-page":"631","DOI":"10.1111\/acem.12171","volume":"20","author":"L Meister","year":"2013","unstructured":"Meister L, Morley EJ, Scheer D, Sinert R. History and physical examination plus laboratory testing for the diagnosis of adult female urinary tract infection. Acad Emerg Med. 2013;20(7):631\u201345.","journal-title":"Acad Emerg Med"},{"issue":"2","key":"3549_CR17","doi-asserted-by":"publisher","first-page":"120","DOI":"10.1086\/501875","volume":"22","author":"M Loeb","year":"2001","unstructured":"Loeb M, Bentley DW, Bradley S, Crossley K, Garibaldi R, Gantz N, et al. Development of minimum criteria for the initiation of antibiotics in residents of long-term-care facilities: results of a consensus conference. Infect Control Hosp Epidemiol. 2001;22(2):120\u20134.","journal-title":"Infect Control Hosp Epidemiol"},{"issue":"5","key":"3549_CR18","doi-asserted-by":"publisher","first-page":"457","DOI":"10.1016\/j.annemergmed.2013.05.003","volume":"62","author":"JH Han","year":"2013","unstructured":"Han JH, Wilson A, Vasilevskis EE, Shintani A, Schnelle JF, Dittus RS, et al. Diagnosing delirium in older emergency department patients: validity and reliability of the delirium triage screen and the brief confusion assessment method. Ann Emerg Med. 2013;62(5):457\u201365.","journal-title":"Ann Emerg Med"},{"key":"3549_CR19","doi-asserted-by":"publisher","first-page":"12","DOI":"10.3352\/jeehp.2013.10.12","volume":"10","author":"M Vassar","year":"2013","unstructured":"Vassar M, Holzmann M. The retrospective chart review: important methodological considerations. J Educ Eval Health Prof. 2013;10:12.","journal-title":"J Educ Eval Health Prof"},{"key":"3549_CR20","doi-asserted-by":"publisher","first-page":"103208","DOI":"10.1016\/j.jbi.2019.103208","volume":"95","author":"PA Harris","year":"2019","unstructured":"Harris PA, Taylor R, Minor BL, Elliott V, Fernandez M, O'Neal L, et al. The REDCap consortium: building an international community of software platform partners. J Biomed Inform. 2019;95:103208.","journal-title":"J Biomed Inform"},{"issue":"2","key":"3549_CR21","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1016\/j.jbi.2008.08.010","volume":"42","author":"PA Harris","year":"2009","unstructured":"Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42(2):377\u201381.","journal-title":"J Biomed Inform"},{"key":"3549_CR22","unstructured":"R Core Team. R: a language and environment for statistical computing Vienna, Austria: R Foundation for Statistical Computing; 2020 [cited 2022 July 28]. Available from: https:\/\/www.R-project.org\/."},{"key":"3549_CR23","unstructured":"Stevenson M, Sergeant E. epiR: Tools for the Analysis of Epidemiological Data [Internet]. 2022 [cited 2022 July 28]. Available from: https:\/\/cran.r-project.org\/web\/packages\/epiR\/index.html."},{"issue":"11","key":"3549_CR24","doi-asserted-by":"publisher","first-page":"1519","DOI":"10.1001\/jamainternmed.2019.2871","volume":"179","author":"LA Petty","year":"2019","unstructured":"Petty LA, Vaughn VM, Flanders SA, Malani AN, Conlon A, Kaye KS, et al. Risk factors and outcomes associated with treatment of asymptomatic bacteriuria in hospitalized patients. JAMA Intern Med. 2019;179(11):1519\u201327.","journal-title":"JAMA Intern Med"},{"issue":"1","key":"3549_CR25","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1017\/ice.2020.369","volume":"42","author":"Y Shpunt","year":"2021","unstructured":"Shpunt Y, Estrin I, Levi Y, Saadon H, Ben-Yossef G, Goldshtein L, et al. Antimicrobial use for asymptomatic bacteriuria\u2014first, do no harm. Infect Control Hosp Epidemiol. 2021;42(1):37\u201342.","journal-title":"Infect Control Hosp Epidemiol"},{"key":"3549_CR26","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1016\/j.archger.2017.05.010","volume":"72","author":"M Dasgupta","year":"2017","unstructured":"Dasgupta M, Brymer C, Elsayed S. Treatment of asymptomatic UTI in older delirious medical in-patients: a prospective cohort study. Arch Gerontol Geriatr. 2017;72:127\u201334.","journal-title":"Arch Gerontol Geriatr"}],"container-title":["BMC Geriatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12877-022-03549-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12877-022-03549-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12877-022-03549-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,11,29]],"date-time":"2022-11-29T12:09:30Z","timestamp":1669723770000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcgeriatr.biomedcentral.com\/articles\/10.1186\/s12877-022-03549-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,29]]},"references-count":26,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["3549"],"URL":"https:\/\/doi.org\/10.1186\/s12877-022-03549-8","relation":{},"ISSN":["1471-2318"],"issn-type":[{"value":"1471-2318","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,29]]},"assertion":[{"value":"8 August 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 October 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 November 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was approved by the Ottawa Health Science Network Research Ethics Board (20190271-01H) and performed in accordance with relevant guidelines and regulations, especially Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans (TCPS 2: CORE, 2018; available from: ). As a retrospective health record review, consent of individual subjects was not required by the Ottawa Health Science Network Research Ethics Board.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"None to declare.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"916"}}