A scoping review of urinary tract infection management in residential aged care settings.

BACKGROUND: Urinary tract infections (UTI) are the most prevalent healthcare associated infection in residential aged care homes (RACH), globally affecting 23.6% of older people in any settings. Management strategies vary significantly by region and organizations. This scoping review evaluates best practice UTI management in RACHs over the last thirteen years. METHODS: A systematic search of Medline, CINAHL, and Embase was conducted to identify studies reporting UTI management in line with current diagnostics criteria, papers published between January 2013 to January 2026 were included. RESULTS: Of 1,112 studies identified, 33 met inclusion criteria and were reviewed. The studies were categorized by outcome with nine evaluating UTI interventions and measuring UTI rates, ten measuring diagnostic accuracy and 19 reporting antimicrobial prescribing. Several studies reported multiple outcomes. DISCUSSION: Current evidence demonstrates that multifaceted UTI management programs including antimicrobial stewardship and a combination of staff education, guidelines, decision-support tools and use of change champions effectively reduce UTI rates. Moreover, diagnostic inconsistencies exist when applying McGeer surveillance criteria, Loeb's minimum criteria, and specific organizational criteria resulting in inappropriate antimicrobial prescribing. CONCLUSION: Further research is required to determine specific responsibilities and selection criteria for change champions to effectively reduce UTI rates. There is an urgent need for a standardized, validated UTI definition to improve diagnostic accuracy and support antimicrobial stewardship for older populations.