Wither proper evaluation of falls for coexisting systemic infections?

The authors should be commended for their work aimed at curbing the overuse of antibiotics by highlighting the problem of frequent overdiagnosis of bacterial infections in long-term care facilities based on nonlocalizing signs and symptoms. The authors’ argument against evaluation of falls as a potential sign of an underlying infection seems to revolve primarily around their concern over providers’ overdiagnosis of urinary tract infections (UTIs) in a patient population at high risk of asymptomatic bacteriuria, which may in turn lead to unnecessary use of antibiotics for presumed urinary tract infection (UTI). [...]nearly one-third of patients with falls seen in the emergency department may be hospitalized7 and nursing-home residents frequently suffer from dementia.8 Thus, we fear that at least some patients for whom evaluation for infection is not recommended by the current SHEA document may well have a CSI that would benefit from earlier diagnosis and treatment.