Treatment of bacteriuria in the absence of symptoms is not indicated, taking into account the potential complications of therapy, including the increasing incidence of Clostridium difficile infection and the risk of precipitating antibiotic resistance [1]. Previous studies among residents in chronic care facilities, have shown that antimicrobial initiation without meeting clinical criteria is common in patients with a suspected urinary tract infection [2]. The problem is even greater among patients with indwelling catheters because: 1) persons with a catheterized urinary tract acquire bacteriuria at the rate of 3–10% per day, when a closed drainage system is used [3], and 2) the population at risk of receiving a catheter-associated urinary tract infection (CAUTI) diagnosis is likely to be cognitive impaired, which can mask possible associated symptoms.
