Author Affiliations: Department of Internal Medicine, Shaare Zedek Medical Center, Jerusalem, Israel (email@example.com).
In Reply: Drs Ga and Kojima mention that PUBS can be a common phenomenon in geriatric patients. According to a literature review by Shiao et al,1 the prevalence of PUBS ranged from 0% to 40%. The review included 4 institutions in which PUBS did not appear at all. This may reflect diversity in the patient population, in the environment, or in the local bacterial epidemiology. In our medical center as well as in other major acute care medical centers in Israel, this phenomenon is quite rare. It may be that many hospitalized patients are treated with antibiotics that prevent the development of PUBS, as has been suggested previously by Ga et al.2
Ben-Chetrit E, Munter G. Purple Urine Bag Syndrome—Reply. JAMA. 2012;307(18):1913. doi:10.1001/jama.2012.3609