Older adults with frailty and urinary tract infections face a high risk of developing sepsis, a new study has found. Clinicians should keep these risk factors in mind when reducing antibiotics, say the authors.

Investigators analyzed database records from 706 primary care practices in the United Kingdom. They sought to determine the incidence of sepsis among patients who received care for an infection — whether they were or were not prescribed antibiotics.

The results revealed that frailty is strongly linked to sepsis, reported Professor Martin C. Gulliford, King’s College London. In fact, a 55-year-old patient with severe frailty was just as likely to develop sepsis as an non-frail 85-year-old, he wrote.

Among all adults aged 55 and older, Gulliford and colleagues found that UTIs were the infection most likely to increase the odds of contracting sepsis, followed by skin infection and respiratory tract infection.

The takeaway? Antibiotics may be reduced more safely in people with a lower probability of sepsis, the researchers said. Among high-risk groups, the benefits of antibiotics may be more substantial among older adults with more advanced frailty and/or UTIs, they concluded. 

The study was published in PLOS Medicine.