At last year’s annual CALTCM meeting, Dr. Peter Patterson gave an excellent presentation on antibiotic stewardship challenging the commonly held view that the bladder is almost always sterile in women in nursing homes.  In fact the literature shows that 20-50% of women have asymptomatic bacteriuria, which will not benefit from antibiotics, but in fact may result in significant harm from their use. Since that time, he has developed a detailed evidenced based implementation strategy for facilities with amazing improvement in meaningful metrics. He is one of the 5 presenters for CALTCM’s Best Practice Session at this year’s annual meeting.  Since working with Dr. Patterson on this project and presentation, I am convinced that his presentation will be one of the practical highlights of this year’s meeting.

Knowing about Dr. Patterson’s work, I read with interest the February 11 issue of the NEJM on UTI in Older Men. This article highlights the near exponential increase in UTIs in men such that by age 85 the incidence is almost that of women.  While men seem to get sicker than women and need antibiotics for much longer, I was struck that older men in LTC have a 15-40% prevalence of asymptomatic bacteriuria.  This means that having strict clinical criteria for UTI are important not only for women, but also for men.  If you have the option for obtaining the full article, I would highly recommend it.

I’m looking forward to Dr. Patterson’s Friday morning presentation which will include multiple non-branded tools that are immediately adaptable in our facilities.

If you haven’t already made the decision, now is the time to jump in and join us for what’s going to be a superb annual meeting.

Link to NEJM article