Age ≥ 60 and admitted to a hospital ward (including rehabilitation hospital);
Active delirium (defined by CAM: \[1\] inattention AND \[2\] acute and fluctuating level of consciousness, and either \[3\] disorganized thinking OR \[4\] altered mental status; OR physician's diagnosis)
Less than 24 hours of antibiotics (prior to trial assessment)
Either pyuria (defined as white blood cells detected on urinalysis or dipstick) or bacteriuria (defined as bacteria growing on urine culture)
You may not be if
Fever (temperature \> 37.9C or \> 100.2F) in the past 48 hours;
Signs of lower urinary tract infection symptoms (such as new dysuria) or upper urinary symptoms (such as costovertebral tenderness)
In the opinion of the treating physician, there is a reason apart from delirium and urine test results to treat with antibiotics (e.g., pneumonia)
Indwelling urinary catheter for \> 72 hours
Receipt of an antibiotic where a single dose suffices for the treatment of a UTI (such as Fosfomycin)
