Development of a recommendation for the use of prophylactic antibiotics for urinary tract infections (UTIs) in elderly patients.

Proposed Title: Development of a recommendation for the use of prophylactic antibiotics for UTIs in elderly patients. This project is derived from the results of previous research, which identified the prescribing of antibiotics for treatment and prophylaxis of urinary tract infections (UTIs) in elderly patients in primary care as an area meriting attention. Presently there is no rational guideline for the prescribing of prophylactic antibiotics, resulting in a haphazard approach to treatment of these patients. Medication appears to be prescribed without clear justification or duration, so that some patients can be left on the same prophylactic antibiotic for months or years. This poor antibiotic stewardship risks causing increasing resistance to these drugs. Guidance is needed on the choice and duration of prophylactic antibiotics; as well as alternative choices and recommended cyclical regimes when these are required. This project will improve antibiotic stewardship, reduce development of resistance, encourage cost-effective prescribing and improve the health of a vulnerable patient group, allowing them to avoid expensive hospital admissions and their unintended consequences (increased frailty, reduced renal function and reduced independence).