Your activity: 6 p.v.
< Back

Minimal criteria for initiation of antimicrobial use for suspected infections in nursing home residents with advanced dementia

Minimal criteria for initiation of antimicrobial use for suspected infections in nursing home residents with advanced dementia
Suspected urinary tract infection Suspected lower respiratory tract infection Suspected skin infection Febrile episode
A. No indwelling Foley catheter
Acute dysuria alone OR
temperature >37.9°C
AND ≥1 of following*:
  1. New or worse frequency
  2. Urgency
  3. Costovertebral tenderness
  4. Gross hematuria
  5. Suprapubic pain
  6. Mental status change
  7. Rigors

B. Indwelling Foley catheter
≥1 of following:
  1. Temperature >37.9°C
  2. Rigors
  3. Change in mental status
A. Temperature >38.9°C
≥1 of following:
  1. Respiratory rate >25 breaths/minute
  2. New productive cough

B. Temperature <38.9°C
New productive cough AND ≥1 of the following:
  1. Pulse >100 beats/minute
  2. Respiratory rate >25 breaths/minute
  3. Rigors
  4. Change in mental status

C. Afebrile with COPD
New/increased cough with purulent sputum 		New or increased purulent drainage
OR ≥1 of the following*:
  1. Temperature >37.9°C
  2. Redness
  3. New or increased swelling
  4. Warmth
  5. Tenderness
Temperature >37.9°C
AND ≥1 of the following:
  1. Change in mental status
  2. Rigors
  3. Unstable vital signsΔ
COPD: chronic obstructive pulmonary disease.
* Urgency, frequency, skin tenderness, costovertebral tenderness, and suprapubic pain may be difficult to evaluate in advanced dementia but accepted criteria if present.
¶ Diagnostic criteria for delirium can be difficult to evaluate in advanced dementia; therefore, any change from baseline mental status considered.
Δ Unstable vital signs = systolic blood pressure <90 mmHg or heart rate >100 beats/minute or respiratory rate >25 breaths/minute.
Graphic 89843 Version 5.0