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

This study is looking for volunteers who are 60 years old or older and have recently been admitted to a hospital ward, including rehabilitation hospitals. To join, you would need to be experiencing delirium (acute confusion) that started or got worse recently, and a doctor would have confirmed this. You would also need to have had fewer than 24 hours of antibiotics for this current illness before being assessed for the study. Additionally, your urine test would need to show either white blood cells or bacteria.

You would not be able to join if you have a fever (temperature over 37.9°C or 100.2°F) in the last two days, or if you have clear signs of a urine infection, like new pain when you wee, or pain in your back or side that suggests a kidney infection. You also wouldn't be able to take part if your doctor feels you need antibiotics for a different reason, like a chest infection, or if you've had a urinary catheter in for more than 72 hours. Finally, if you've already received a specific single-dose antibiotic for a urine infection, you wouldn't be eligible.

If you decide to take part in this study, you would first have a full assessment to see if you meet all the requirements. If you do, you would then be randomly sorted into one of three groups. One group would receive antibiotics for their bacteriuria (bacteria in urine), another group would continue any antibiotics they might have already started, and a third group would not receive antibiotics specifically for the bacteria in their urine. The study team would carefully monitor your health and your delirium throughout your hospital stay. They would also keep track of any changes in your condition or symptoms. The total duration of your participation would depend on how long you remain in hospital until your condition is stable or you are discharged.