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Antibiotics for Delirium in Older Adults With No Clear Urinary Tract Infection

RecruitingNAAges 60 Years - anyAllMount Sinai Hospital, Canada
NCT06004739 on ClinicalTrials.gov ↗
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In plain words

What the trial is, and whether it could suit you

Delirium is an acute confusional state that is experienced by many older adults who are admitted to hospital. To treat delirium the underlying cause needs to be identified promptly, but this is challenging. One of the potential causes of delirium is infection. Urine tests show that most patients experiencing delirium have bacteria in their urine, however, bacteria in the urine is common among older adults, and does not automatically indicate an infection is present. As a result it is difficult to know whether a lower urinary tract infection is present as individuals with delirium are frequently unable to report clinical signs of infection - symptoms of pain or discomfort with urination, having to urinate more frequently or pelvic discomfort. Very often, individuals with delirium are treated with antibiotics despite the fact that it is unknown whether antibiotics help to improve delirium

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📋 Eligibility rules (as published)
Inclusion criteria * Age ≥ 60 and admitted to a hospital ward (including rehabilitation hospital); * Active delirium (defined by CAM: \[1\] inattention AND \[2\] acute and fluctuating level of consciousness, and either \[3\] disorganized thinking OR \[4\] altered mental status; OR physician's diagnosis) * Less than 24 hours of antibiotics (prior to trial assessment) * Either pyuria (defined as white blood cells detected on urinalysis or dipstick) or bacteriuria (defined as bacteria growing on urine culture) Exclusion criteria * Fever (temperature \> 37.9C or \> 100.2F) in the past 48 hours; * Signs of lower urinary tract infection symptoms (such as new dysuria) or upper urinary symptoms (such as costovertebral tenderness) * In the opinion of the treating physician, there is a reason apart from delirium and urine test results to treat with antibiotics (e.g., pneumonia) * Indwelling urinary catheter for \> 72 hours * Receipt of an antibiotic where a single dose suffices for the treatment of a UTI (such as Fosfomycin)
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What it tests

  • Start Antibiotics / Continue Antibiotics for treatment of bacteriuria
  • No Antibiotics for treatment of bacteriuria
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Where

7 sites
Northwestern Memorial Hospital
Chicago, United States
The Ottawa Hospital Civic Campus
Ottawa, Canada
The Ottawa Hospital General Campus
Ottawa, Canada
Hennick Bridgepoint Hospital
Toronto, Canada
Michael Garron Hospital
Toronto, Canada
Mount Sinai Hospital
Toronto, Canada
Toronto General Hospital
Toronto, Canada
🤝 Taking part is your choice, and you can leave at any time. Only the trial team can confirm you are eligible — always decide together with your own doctor.
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