The quality of these included studies varied, with frequent poor case definitions for UTI or confusion contributing to large variation in results and limiting their validity. One thousand seven hunderd two original records were identified, of which 22 were included in the final analysis. Data were extracted using a standardised extraction tool and a qualitative synthesis of evidence was made. Quality assessment was conducted independently by two authors. Inclusion criteria and methods were specified in advance and documented in the protocol, which was published with PROSPERO (registration ID: CRD42015025804). PubMed, Scopus and PsychInfo were searched with the following terms: confusion, delirium, altered mental status, acute confusional state, urinary tract infection, urine infection, urinary infection and bacteriuria. MethodsĪ systematic review of the literature was conducted assessing the association between confusion and UTI in the elderly. This problem is particularly prevalent in nursing home settings. This leads to significant overdiagnosis of UTI, inappropriate antibiotic use and potential harmful outcomes. Non-specific symptoms, such as confusion, are often suspected to be caused by urinary tract infection (UTI) and continues to be the most common reason for suspecting a UTI despite many other potential causes.
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