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Asymptomatic bacteriuria in a catheterised older adult — SCE Acute Medicine MCQ

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HardMedicine in the elderlyAsymptomatic bacteriuria in a catheterised older adultSCE Acute Medicine

An 89-year-old woman with a long-term catheter is admitted after a fall. She is afebrile, haemodynamically stable and denies suprapubic pain or flank pain. Urine is cloudy and dipstick is positive for nitrites and leucocytes; blood tests show no inflammatory response. What is the most appropriate next step in management?

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Correct answer: C — Do not treat asymptomatic bacteriuria and assess other causes of the fall

Catheterised older adults commonly have bacteriuria and pyuria, which do not diagnose symptomatic UTI in the absence of compatible features. Treating asymptomatic bacteriuria drives harm through adverse effects and antimicrobial resistance. Falls require broad assessment rather than anchoring on a urine dipstick.

Reference: NICE NG113 urinary tract infection antimicrobial prescribing; NICE CG161 falls