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Different patterns in use of antibiotics for lower urinary tract infection in institutionalized and home-dwelling elderly: a register-based study

  • Pharmacoepidemiology and Prescription
  • Published:
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Abstract

Purpose

We compared the quality and pattern of use of antibiotics to treat urinary tract infection (UTI) between institutionalized and home-dwelling elderly.

Methods

We analyzed the quality of use of UTI antibiotics in Swedish people aged ≥65 years at 30 September 2008 (1,260,843 home-dwelling and 86,721 institutionalized elderly). Data regarding drug use, age and sex were retrieved from the Swedish Prescribed Drug Register and information about type of housing from the Social Services Register. In women, we assessed: (1) the proportion who use quinolones (should be as low as possible); (2) the proportion treated with the recommended drugs (pivmecillinam, nitrofurantoin, or trimethoprim) (proportions should be about 40 %, 40 % and 15–20 %, respectively); In men, we assessed: (1) the proportion who used quinolones or trimethoprim (should be as high as possible).

Results

The 1-day point prevalence for antibiotic use for UTI was 1.6 % among institutionalized and 0.9 % among home-dwelling elderly. Of these, about 15 % of institutionalized and 19 % of home-dwelling women used quinolones. The proportion of women treated with the recommended drugs pivmecillinam, nitrofurantoin or trimethoprim was 29 %, 27 % and 45 % in institutions and 40 %, 28 % and 34 % for home-dwellers. In men treated with antibiotics for UTI, quinolones or trimethoprim were used by about 76 % in institutions and 85 % in home-dwellers.

Conclusions

Our results indicate that recommendations for UTI treatment with antibiotics are not adequately followed. The high use of trimethoprim amongst institutionalized women and the low use of quinolones or trimethoprim among institutionalized men need further investigation.

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Acknowledgments

We thank the National Board of Health and Welfare for providing data. We also thank Christer Norman for discussion about the results. This study was supported financially by the Swedish Research Council (DNR 2007-5870) and by the Karolinska Institutet KID-grant.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Aging Research Center, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet and Stockholm University, Gävlegatan 16, 113 30, Stockholm, Sweden

    Ylva Haasum, Johan Fastbom & Kristina Johnell

  2. Stockholm Gerontology Research Center, Stockholm, Sweden

    Ylva Haasum, Johan Fastbom & Kristina Johnell

Authors
  1. Ylva Haasum
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  2. Johan Fastbom
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  3. Kristina Johnell
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Corresponding author

Correspondence to Ylva Haasum.

Additional information

A previous version of this work was included in my thesis: Haasum Y (2012) Drug use in institutionalized and home-dwelling elderly persons. Dissertation, Karolinska Institutet

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Haasum, Y., Fastbom, J. & Johnell, K. Different patterns in use of antibiotics for lower urinary tract infection in institutionalized and home-dwelling elderly: a register-based study. Eur J Clin Pharmacol 69, 665–671 (2013). https://doi.org/10.1007/s00228-012-1374-7

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  • DOI: https://doi.org/10.1007/s00228-012-1374-7

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