Antibiotics for asymptomatic bacteriuria

Trestioreanu, Anca Zalmanovici; Lador, Adi; Sauerbrun‐Cutler, May‐Tal; Leibovici, Leonard

doi:10.1002/14651858.cd009534.pub2

Cited by 59 publications

(34 citation statements)

References 58 publications

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“…Third, lack of antibiotic treatment for ASB was not associated with a higher risk of postoperative PJI due to a microorganism previously found in the urine or a higher risk of postoperative symptomatic UTI. These findings are in line with results from large meta-analyses showing no differences between antibiotic treatment and no treatment of ASB for the development of symptomatic UTI 24 .…”

Section: Treatment Of Asb In Patients Undergoing Surgery For Joint Resupporting

confidence: 88%

“…The power calculation is also important to highlight collateral damages caused by unnecessary use of antibiotics. Antibiotic treatment for ASB is associated with significantly more adverse events and the development of resistance 24 , 29 . Unfortunately, ASB has become a major cause of inappropriate antimicrobial use 30 , 31 .…”

Section: Treatment Of Asb In Patients Undergoing Surgery For Joint Rementioning

confidence: 99%

See 1 more Smart Citation

Management of Asymptomatic Bacteriuria, Urinary Catheters and Symptomatic Urinary Tract Infections in Patients Undergoing Surgery for Joint Replacement: A Position Paper of the Expert Group 'Infection' of swissorthopaedics

Sendi

Borens

Wahl

et al. 2017

J. Bone Joint Infect.

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In this position paper, we review definitions related to this subject and the corresponding literature. Our recommendations include the following statements. Asymptomatic bacteriuria, asymptomatic leukocyturia, urine discolouration, odd smell or positive nitrite sediments are not an indication for antimicrobial treatment. Antimicrobial treatment of asymptomatic bacteriuria does not prevent periprosthetic joint infection, but is associated with adverse events, costs and antibiotic resistance development. Urine analyses or urine cultures in asymptomatic patients undergoing orthopaedic implants should be avoided. Indwelling urinary catheters are the most frequent reason for healthcare-associated urinary tract infections and should be avoided or removed as soon as possible.

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Section: Treatment Of Asb In Patients Undergoing Surgery For Joint Resupporting

confidence: 88%

Section: Treatment Of Asb In Patients Undergoing Surgery For Joint Rementioning

confidence: 99%

Management of Asymptomatic Bacteriuria, Urinary Catheters and Symptomatic Urinary Tract Infections in Patients Undergoing Surgery for Joint Replacement: A Position Paper of the Expert Group 'Infection' of swissorthopaedics

Sendi

Borens

Wahl

et al. 2017

J. Bone Joint Infect.

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“…In the context of “choosing wisely”, the antibiotic treatment of ASB is controversial [39]. A Cochrane Renal Group’s Specialized Register analysis could not find a clinical benefit of ASB treatment [40]. Even in the cohort of kidney transplant patients, treatment strategies for ASB are currently changing.…”

Section: Discussionmentioning

confidence: 99%

Increased resistance of gram-negative urinary pathogens after kidney transplantation

et al. 2017

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BackgroundUrinary tract infection is the most common complication after kidney transplantation. It can cause severe sepsis and transplant loss. Emergence of drug resistance among gram-negative urinary pathogens is the current challenge for urinary tract infection treatment after kidney transplantation.MethodsThis study analyzes the antimicrobial susceptibility of gram-negative urinary pathogens after kidney transplantation from 2009 to 2012 at the Transplant Outpatient Clinic of the University Hospital Essen, Germany. Kidney transplant patients at the University Hospital Essen receive regular follow up examinations after transplantation. Midstream urines were examined for bacteriuria at each follow up visit.ResultsFrom 2009 to 2012 15.741 urine samples were obtained from 859 patients. In 2985 (19%) samples bacterial growth was detected. The most frequently detected gram-negative bacteria were E.coli 1109 (37%), Klebsiella spp. 242 (8%) and Pseudomonas aeruginosa 136 (4.5%). Klebsiella spp. showed a significant increase of resistance to trimethoprim-sulfamethoxazole by 19% (p = 0.02), ciprofloxacin by 15% (p = 0.01) and ceftazidime by 17% (p = 0.004). E.coli and P. aeruginosa isolates presented no significant differences of antimicrobial susceptibility to the analyzed antibiotics.ConclusionsAntimicrobial resistance of Klebsiella spp. increased significant to trimethoprim-sulfamethoxazole, ciprofloxacin and ceftazidime from 2009 to 2012.

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“…Asymptomatic bacteriuria is more common in women than men and is most frequent among hospitalized patients and residents of long-term care facilities (up to 50% of women in these high risk groups) ( 18 ). Use of antibiotics in this situation is inappropriate ( 19 ) and may contribute to antimicrobial resistance.…”

Section: Normal Agingmentioning

confidence: 99%

Age-Related Diseases and Clinical and Public Health Implications for the 85 Years Old and Over Population

Jaul

Barron

2017

Front. Public Health

675

424

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By 2050, the American 85 years old and over population will triple. Clinicians and the public health community need to develop a culture of sensitivity to the needs of this population and its subgroups. Sensory changes, cognitive changes, and weakness may be subtle or may be severe in the heterogeneous population of people over age 85. Falls, cardiovascular disease, and difficulty with activities of daily living are common but not universal. This paper reviews relevant changes of normal aging, diseases, and syndromes common in people over age 85, cognitive and psychological changes, social and environmental changes, and then reviews common discussions which clinicians routinely have with these patients and their families. Some hearing and vision loss are a part of normal aging as is decline in immune function. Cardiovascular disease and osteoporosis and dementia are common chronic conditions at age 85. Osteoarthritis, diabetes, and related mobility disability will increase in prevalence as the population ages and becomes more overweight. These population changes have considerable public health importance. Caregiver support, services in the home, assistive technologies, and promotion of home exercise programs as well as consideration of transportation and housing policies are recommended. For clinicians, judicious prescribing and ordering of tests includes a consideration of life expectancy, lag time to benefit, and patient goals. Furthermore, healthy behaviors starting in early childhood can optimize quality of life among the oldest-old.

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Antibiotics for asymptomatic bacteriuria

Cited by 59 publications

References 58 publications

Management of Asymptomatic Bacteriuria, Urinary Catheters and Symptomatic Urinary Tract Infections in Patients Undergoing Surgery for Joint Replacement: A Position Paper of the Expert Group 'Infection' of swissorthopaedics

Management of Asymptomatic Bacteriuria, Urinary Catheters and Symptomatic Urinary Tract Infections in Patients Undergoing Surgery for Joint Replacement: A Position Paper of the Expert Group 'Infection' of swissorthopaedics

Increased resistance of gram-negative urinary pathogens after kidney transplantation

Age-Related Diseases and Clinical and Public Health Implications for the 85 Years Old and Over Population

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