A health record review was conducted at a tertiary academic centre from January to December 2020. Inclusion criteria were age ≥ 65, positive delirium screening assessment, positive urinalysis, and admission to general medical units. Outcomes included rates of antibiotic treatment, delirium on day 7 of admission, and 30-day adverse outcomes. We compared delirium and adverse outcome rates in antibiotic-treated vs. non-treated groups. We conducted subgroup analyses among asymptomatic patients.
We included 150 patients (57% female, mean age 85.4 years). Antibiotics were given to 86%. The asymptomatic subgroup (delirium without urinary symptoms or fever) comprised 38% and antibiotic treatment rate in this subgroup was 68%. There was no significant difference in delirium rate on day 7 between antibiotic-treated vs. non-treated groups, (entire cohort RR 0.94 [0.41-2.16] and asymptomatic subgroup RR 0.69 [0.22-2.15]) or in 30-day adverse outcomes.
Older adults with delirium and positive urinalysis in general medical inpatient units were frequently treated with antibiotics - often despite the absence of urinary or other infectious symptoms. We failed to find evidence that antibiotic treatment in this population is associated with delirium resolution on day 7 of admission.
2020年1月至12月,在一个三级学术中心进行了健康记录审查。纳入标准为年龄≥65岁,谵妄筛查评估阳性,尿液分析阳性,进入普通医疗单位。结果包括抗生素治疗的比率,入院第7天谵妄,和30天的不良结果。我们比较了抗生素治疗的谵妄和不良结局率与非治疗组。我们在无症状患者中进行了亚组分析。
我们纳入了150名患者(57%为女性,平均年龄85.4岁)。抗生素的比例为86%。无症状亚组(无泌尿系症状或发热的谵妄)占38%,该亚组的抗生素治疗率为68%。抗生素治疗与抗生素治疗的第7天的谵妄率没有显着差异。非治疗组,(整个队列RR0.94[0.41-2.16]和无症状亚组RR0.69[0.22-2.15])或30天不良结局。
在普通内科住院病房中,患有谵妄和尿液分析阳性的老年人经常使用抗生素治疗-通常尽管没有泌尿或其他感染症状。我们没有发现证据表明该人群的抗生素治疗与入院第7天的谵妄消退有关。