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KMID : 1234520080030020160
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Korean Journal of Urogenital Tract Infection Inflammation
2008 Volume.3 No. 2 p.160 ~ p.165
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Urinary Tract Infections and Bacteriuria in the Elderly: Diagnosis and Treatment
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Kim Duk-Yoon
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Abstract
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The elderly population is now increasing in the world. A higher incidence of bacteriuria and urinary tract infection (UTI) is observed in the elderly patients, in both long-term care facilities and at home. The management of elderly patients with UTI is increasing in clinical significance. Bacteriuria (≥ 105 CFU/ml) is a very common phenomenon in the elderly people, occurring twice as frequently in women than in men. Almost all of UTI in the elderly is complicated UTI. Control of the underlying diseases in the urinary tract is quite important in the management of UTIs in the elderly patients. For pyelonephritis, switch therapy using aminoglycosides and fluoroquinolones, carbapenems, third-generation cephalosporines, or penicillins are selections of choice. The recommended duration of treatment for patients with pyelonephritis is 14 days. Seven to 10 days of treatment using fluoroquinolones or trimethoprim-sulfamethoxazole is recommended for the treatment of elderly patients with symptomatic cystitis. There are symptomatic and asymptomatic types of bacteriuria. Although asymptomatic bacteriuria is quite common in the elderly population, antibiotic treatment
has no benefit for such patients. Intravaginal estrogen replacement is one of choice for the prevention of recurrent UTIs in postmenopausal women.
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KEYWORD
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Urinary tract infection, Elderly
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