Urinary tract infections in the elderly

Definitions: Age over 65 years is generally used to define the elderly popu lation. Urinary tract infections are increasingly frequent after this age. Comorbidity and living conditions in the elderly have a particular incidenc e on the clinical expression and the bacterial flora involved. Besides thes e elements, altered cognitive capacity and abnormal urinary function prior to the infection and lead to an atypical clinical presentation. Asymptomatic bacteriuria: Systematic screening has produced a large body of literature on asymptomatic bacteriuria. Our review of the literature leads to the conclusion that systematic bacteriology tests are not warranted in the elderly population in general selection and erroneous diagnosis. Practical attitude: The diagnosis of urinary infection must be evidence-bas ed, taking into account the patient's history and ruling out other diagnose s. In all cases, antibiotics must be carefully adapted to the patient's sit uation and titrated to kidney function.