The Truth About Antibiotics and Aging: What Families Should Know

Here’s an age-old truth: Maryland’s population is aging slightly faster than the rest of the country, meaning more families here are navigating the complexities of caring for older loved ones. At Luminis Health, we are committed to Age-Friendly Care—an approach that centers on what matters most to older adults and their families. We follow the nationally recognized 4M’s framework: What Matters, Medication, Mentation, and Mobility.

What is Asymptomatic Bacteriuria?

One important topic that can be tough to talk about and causes confusion is asymptomatic bacteriuria.  This happens when bacteria are found in the urine, but there are no symptoms of infection. This condition is very common in older adults, especially women after menopause, when lower estrogen levels reduce protective bacteria.

Unfortunately, asymptomatic bacteriuria is often mistaken for a urinary tract infection (UTI), leading to unnecessary prescriptions for antibiotics. Here’s what you should know about asymptomatic bacteriuria:

• It’s not a UTI. Asymptomatic bacteriuria is different from an infection. A positive urine culture or high white blood cell count doesn’t always mean antibiotics are needed.
• It does not cause confusion, falls, or weakness. If your loved one is experiencing these symptoms, it could possibly be dehydration, electrolyte imbalance, or medications.
• Antibiotics are often unnecessary and can be harmful. Overuse of antibiotics offers no benefit in treating this condition and can increase risks of diarrhea, colitis, allergic reactions, drug interactions, and dangerous drug-resistant infections and worse.
• There are safer alternatives. Good daily hygiene with perineal cleaning, vaginal creams, and probiotics can help restore protective bacteria and pH without the risks of antibiotics.
   

So, when do antibiotics make sense? Only when your care provider carefully assesses symptoms, reviews medical history, and determines there are true signs of infection. This is where the 4M’s guide our patient-centered care.
 

The 4M's to Patient-Centered Care
 

What Matters

Listening to patients and families about their goals, comfort, and preferences.
 

Medication

Avoiding unnecessary antibiotics that can do more harm than good.
 

Mentation

Recognizing that confusion in older adults has many causes, not just bacteria in the urine.
 

Mobility

Helping older adults stay active and safe, instead of sidelined by side effects from inappropriate treatment.

By following this evidence-based approach, we ensure older adults get the right care at the right time—protecting their health, independence, and quality of life.
 

Age-Friendly Care

Luminis Health is committed to championing Age-Friendly Care for our community. We’re proud that Luminis Health Anne Arundel Medical Center in Annapolis is one of only five hospitals nationwide recognized as an Age-Friendly Health System Pioneer by the Institute for Healthcare Improvement. Luminis Health Doctors Community Medical Center in Lanham, along with our primary care practices, have earned the Age-Friendly Healthy System Level 2 – Committed to Care Excellence designation.

As Maryland continues to age ahead of the national curve, these conversations matter more than ever—for our parents, grandparents, and all of us who love them.

View our Antibiotics Flyer here.