21st Journal Club Article

Following Article posted by Kay Mackey, BSN, RN, clinical nurse, OR and virtual journal club member.  https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-019-1049-7

Kayla shared the following, 

"I used to work on the med-surg floors, and I remember frequently getting elderly patients that would come in with increased confusion and they would be diagnosed with urinary tract infection, however, there was not always the typical indications of prescribing antibiotics in these cases; onset localizing genitourinary signs and symptoms and positive urine culture. This is further complicated by the high prevalence of asymptomatic bacteriuria in nursing home residents. However, according to sound evidence, the indications to treat with antibiotics are elderly residenets with symptomatic lower UTI should received antiobiic treatment and elderly reseidents with asymptomatic bacteriura should not. Which led me to think, how does one decipher when it is truly a urinary tract infection or when it can be another issue at hand? Especially with the over prescribing of antibiotics, I found this article to be interesting.

Four questions I would have regarding this article would include:

1. Based off of the article, do you think increased confusion should be included as an indication for the prescribing of antibiotics when a UTI has not been confirmed by a positive urine culture in elderly patients?
2. Do you think the authors method of inclusion and exclusion criteria was appropriate when it came to the objective?
3. Do you feel that there were enough articles after the inclusion and exclusion criteria were applied to form a sound conclusion?
4. What are your thoughts on this subject?"