Diagnosis and Management of Urinary Tract Infections in Older Women
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Educational Objectives
1. To identify risk factors associated with the development of UTI in older women
2. To understand the management of asymptomatic bacteriuria
3. To be able to recommend antimicrobial treatment for UTI in older women
4. To understand the major side effects and drug interactions associated with antimicrobials used to treat UTI
ACCREDITATION
The Johns Hopkins University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The Johns Hopkins University School of Medicine takes responsibility for the content, quality, and scientific integrity of this CME activity.
CREDIT DESIGNATION STATEMENT
The Johns Hopkins University School of Medicine designates this educational activity for a maximum of 1.0 category 1 credit toward the AMA Physician’s Recognition Award. Each physician should claim only those hours of credit that he/she actually spent in the educational activity. Valid May 1 - July 31, 2005. Estimated time: 1 hour
FULL DISCLOSURE POLICY AFFECTING CME ACTIVITIES
As a provider accredited by the Accreditation Council for Continuing Medical Education (ACCME), it is the policy of Johns Hopkins University School of Medicine to require the disclosure of the existence of any significant financial interest or any other relationship a faculty member or provider has with the manufacturer(s) of any commercial product(s) discussed in an educational presentation. The presenting faculty reported the following: Dr. Malani has indicated that she has not received financial support for consultation, research or evaluation or has a financial interest relevant to this article. No faculty member has indicated that their presentation will include information on off-label products.
DISCLAIMER STATEMENT
The opinions and recommendations expressed by faculty and other experts whose input is included in this program are their own. This enduring material is produced for educational purposes only. Use of Johns Hopkins University School of Medicine name implies review of educational format design and approach. Please review the complete prescribing information of specific drugs or combination of drugs, including indications, contraindications, warnings and adverse effects before administering pharmacologic therapy to patients.
Urinary tract infections (UTIs) are among the most common infectious diseases in older women. Urinary tract infections in community-dwelling older women differ in terms of causative agents, risk factors, and treatment from those noted in women living in long-term care facilities. Escherichia coli remains the most common pathogen; however, gram-negative bacilli are prominent in residents of long-term care facilities. Although some predisposing factors are the same as those found in younger women, older women have additional physiological and anatomical risk factors that contribute to the development of UTIs. These differences must be taken into consideration when selecting management strategies. The use of indwelling catheters, poor functional status, and underlying medical conditions in residents of long-term care facilities contribute to an increased risk for UTIs. Antimicrobial therapy for uncomplicated UTIs is similar to that in young women, but complicated UTIs require longer courses of therapy and correction of underlying predisposing factors when feasible.
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