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Uncomplicated Cystitis in Nursing Home Residents: A Practical Guide to Diagnosis and Management

      Suspected urinary tract infections (UTIs) are the most commonly encountered and treated infections in nursing homes.
      • Zimmerman S.
      • Sloane P.D.
      • Bertrand R.
      • et al.
      Successfully reducing antibiotic prescribing in nursing homes.
      • Dwyer L.L.
      • Harris-Kojetin L.D.
      • Valverde R.H.
      • et al.
      Infections in long-term care populations in the United States.
      The incidence of symptomatic UTI approaches 2.5 cases per 1000 resident-days,
      • Nicolle L.E.
      Urinary tract infection in long-term care facilities.
      and approximately one-third of antibiotics administered in nursing homes are attributable to UTI.
      • Thompson N.D.
      • LaPlace L.
      • Epstein L.
      • et al.
      Prevalence of antimicrobial use and opportunities to improve prescribing practices in U.S. nursing homes.
      Nevertheless, most antibiotic prescriptions for suspected UTI in nursing homes are inappropriate,
      • Eure T.
      • LaPlace L.L.
      • Melchreit R.
      • et al.
      Measuring antibiotic appropriateness for urinary tract infections in nursing home residents.
      resulting in high risks of antibiotic-associated harms, including an 8-fold greater odds of Clostridium difficile infection when compared to unexposed residents.
      • Rotjanapan P.
      • Dosa D.
      • Thomas K.S.
      Potentially inappropriate treatment of urinary tract infections in two Rhode Island nursing homes.
      Consequently, antibiotic stewardship programs are now mandated by the Centers for Medicare and Medicaid Services.
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