Antibiotics reduce UTI-related delirium in preclinical study

Antibiotics could help prevent or reverse symptoms of delirium in patients with urinary tract infections (UTIs), according to a preclinical study in laboratory mice conducted by Cedars-Sinai investigators. Their findings, published in the journal Translational Psychiatry, could change treatment guidelines if validated through clinical studies in human patients.

Delirium is common among patients with urinary tract infection—and can also increase long-term dementia risk, said Shouri Lahiri, MD, director of Neuroscience Critical Care and Neurocritical Care Research, associate professor of Neurology at Cedars-Sinai, and senior author of the study.

Delirium refers to a sudden disturbance in brain functions including attention, awareness and cognition, usually caused by an underlying infection like UTI or pneumonia. Patients with delirium often ramble and are disoriented, have memory problems and may experience hallucinations or paranoia.

“Our goal was to address a key clinical controversy around whether or not antibiotics help when delirium is the only sign of a possible urinary tract infection,” Lahiri said. “Our findings challenge current guidelines that recommend against antibiotics for delirious patients without urinary symptoms and could change clinical practice.”

Investigators working with laboratory mice with urinary tract infections found that these mice developed hallmarks of delirium including inattention, memory problems and anxiety—and signs of brain injury and inflammation. Mice treated with antibiotics showed improved symptoms and reduced brain injury, with early treatment proving more effective than delayed treatment.