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Br J Community Nurs. 2019 Mar 2;24(3):116-119. doi: 10.12968/bjcn.2019.24.3.116.

Alternative to antibiotics for managing asymptomatic and non-symptomatic bacteriuria in older persons: a review.

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Lecturer (Education), School of Nursing and Midwifery, Queens University, Belfast.


Recurrent urinary tract infection (UTI) is one of the most common reasons for long-term antibiotic use in frail older people, and these individuals often have non-symptomatic bacteriuria. This article reviews the literature and recommendations for the treatment of UTIs particularly in the older population (>65 years). It considers the question: is there an alternative for antibiotics for asymptomatic and non-symptomatic bacteriuria in older adults? D-mannose powder has been recommended for the treatment of UTIs, as when applied locally, it reduces the adherence of Escherichia coli. In one study, D-mannose was reviewed for the prophylaxis of recurrent UTIs in women, and the findings indicated that it may be useful for UTI prevention instead of prophylactic antibiotics. There is a lack of information about the efficacy of cranberry products combined with D-mannose in this regard, and this is an area for further research.


; Antibiotic prophylaxis; Asymptomatic and non-symptomatic bacteriuria; Older adults; Recurrent urinary tract infection

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