BEHAVIORAL AND PSYCHOSOCIAL INFLUENCES ON TREATMENT SUCCESS FOR URINARY TRACT INFECTIONS IN ELDERLY PATIENTS

RESUMO

Moamen Abdelfadil Ismail, Taleb Hussain Ali Aldandan, Hussain Mohammed Albin Hamdhah, Rayan Abdullah Alamri, Mohammed Saeed Alqahtani, Esam mohammed Alamri, Suliman Salah Alsowaigh, Muath Mohammed Alahmari*, Abdulsalam Kreem Alzarea, Abdulelah Abdulhadi Alruwaili, Abdulaziz A. Alhumam

Background: Urinary tract infections are a very common type of infection in the urinary system. It's more common in female, Elderly, recent catheterization and Sexual Activity. The disease can involve any part of your urinary system from a relatively benign cystitis to potentially life-threatening pyelonephritis. They are the most common infection among elderly population and the most common cause of hospitalization. The diagnosis and treatment of urinary tract infections in elderly people is considered difficult due to certain risk factors include diabetes mellitus, aging, impaired immunity, spinal cord injuries and the use of urinary catheters.

Methods: A retrospective observational study was conducted between January 2020 and December 2024. A total of 350 elderly patients (≥65 years) diagnosed with urinary tract infections were included. Data were extracted from electronic medical records, including sociodemographic characteristics, comorbidities, medication regimens, and treatment outcomes. Descriptive statistics were used to summarize data, and logistic regression was performed to identify predictors of poor treatment outcomes.

Results: Among the study population, 63.5% had complicated urinary tract infections, with hypertension (62.4%) and diabetes mellitus (48.2%) being the most common comorbidities. Polypharmacy (≥5 medications) was present in 63.5% of patients, and 14.1% were on ≥10 medications. Nitrofurantoin (32.9%) and ciprofloxacin (25.9%) were the most commonly prescribed antibiotics. Older age (≥85 years, OR=2.5, p<0.001), diabetes mellitus (OR=1.9, p<0.001), chronic kidney disease (OR=2.2, p<0.001), urinary catheterization history (OR=2.8, p<0.001), and polypharmacy (OR=1.7, p=0.002) were significant predictors of poor treatment outcomes.

Conclusion: Elderly patients with urinary tract infections frequently present with multiple comorbidities and high medication burdens, complicating treatment and increasing the risk of adverse outcomes. Polypharmacy and chronic conditions such as diabetes and chronic kidney disease significantly impact treatment success. Improved antibiotic stewardship and individualized treatment strategies are needed to optimize outcomes in this vulnerable population.