Suspected urine infection (UTI) in older adults >65 years

TAM (Treatments and Medicines) NHS Highland
NHS Highland

Audience

  • All NHS Highland
  • Primary and Secondary care
  • Adults only

This guidance is adapted from the Scottish Antimicrobial Prescribing Group (SAPG) UTI assessment tool aimed at patients in care homes but applicable to all older adults in acute hospitals and in the community.

  • The assessment tool can be used by all staff caring for older adults.
  • See also Diagnosis of UTI Urology guidelines. 

Objective

  • Ensure there is appropriate antibiotic prescriptions where there is clinical evidence of infection.  
  • To reduce the incidence of antibiotic resistance and the risk of potential HAI's (e.g. C difficile)
  • To reduce the number of inappropriate urine cultures sent to microbiology
  • To improve documentation and patient safety
  • To ensure where a urine culture is required, the referral / request form and specimen container are sent appropriately

Many urine samples are rejected due to leakage and inadequate details on the referral form. This can result in a delay in treatment for patients AND a delay in the correct treatment for the infection indicated

Suspected Urine Infection (UTI) in older adults >65 years

For a printable version: Click here (NHS Highland intranet access required)

 

Abbreviations

C.Diff: Clostridioides difficile
CHI: Community Health Index
CSU: Catheter Specimen of Urine
EAU: European Association of Urology
HAI: Healthcare-Associated Infection
MSSU: Mid-Stream Specimen of Urine
SAPG: Scottish Antimicrobial Prescribing Group
TIME: Think, Investigate, Manage, Engage (delirium assessment bundle – referenced in context)
UTI: Urinary Tract Infection

Editorial Information

Last reviewed: 03/03/2026

Next review date: 01/03/2029

Author(s): Older Adult Medicine.

Version: 1.1

Co-Author(s): Antimicrobial Management Team.

Approved By: TAM subgroup of the ADTC

Reviewer name(s): H McCloughlin (NHS Highland), Senior Advanced Nurse Practitioner in Older Adult Medicine.

Document Id: TAM749