Antibiotics for asymptomatic bacteriuria in pregnancy

Smaill, Fiona; Vázquez, Juan C

doi:10.1002/14651858.cd000490.pub3

Cited by 318 publications

(207 citation statements)

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“…Treatment and clearance of bacteria in the pregnant women requires that sensitive antibiotics be identified by culture sensitivity test where possible [6][7][8][9][10][11][12][13][14][15]. If ASB is not treated appropriately in pregnancy, it is associated with up to 50% risk of developing pyelonephritis later in pregnancy which is associated with adverse pregnancy outcomes [5][6][7][8][9][10][11][12][13][14][15]. It is, however argued that extensive use of antibiotics even to treat ASB in pregnancy could increase bacterial resistance to alarming level [13].…”

Section: Discussionmentioning

confidence: 99%

“…When ASB is untreated in pregnancy it often progresses later in pregnancy to pyelonephritis, an acute (UTI) [5]. Pyelonephritis is symptomatic bacteriuria associated with several pregnancy complications and adverse birth outcomes including pre-eclampsia, preterm birth, low birth weight and neonatal death [6,7]. Up to 40% of pregnant women develop a symptomatic UTI later in pregnancy if ASB is undetected and untreated [3,8,5].…”

Section: Introductionmentioning

confidence: 99%

“…Screening and treatment of ASB during pregnancy is an important intervention to be implemented at primary care level [9]. Treatment of ASB in pregnancy using effective antibacterial treatment decreases risk of acute urinary tract infection from 40% to 1 to 4% [3][4][5][6][7][8][9][10]. All complications of ASB during pregnancy are reduced by antibiotic therapy [9].…”

Section: Introductionmentioning

confidence: 99%

“…All complications of ASB during pregnancy are reduced by antibiotic therapy [9]. Several international and national guidelines recommend screening and treatment of ASB to reduce risk of pyelonephritis [6]. Several antibiotics are available for selection for treatment of ASB in pregnancy including, amoxil, ampicillin, cephasporin, nitrofurantoin, trimethoprim and sulfamethoxazole [2].…”

Section: Introductionmentioning

confidence: 99%

“…Several antibiotics are available for selection for treatment of ASB in pregnancy including, amoxil, ampicillin, cephasporin, nitrofurantoin, trimethoprim and sulfamethoxazole [2]. Treatment of ASB with antibiotics in pregnancy aims to clear the infection, which is only possible if the isolated bacterium is susceptible to it [6]. Selection of antibiotic to treat ASB need to be based on antibiotic susceptibility results [9].…”

Section: Introductionmentioning

confidence: 99%

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2017

MOJI

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Background and objective: Effective treatment of asymptomatic bacteriuria in pregnancy requires susceptible drugs. The aim of this study was to determine antibiotic susceptibility pattern among isolated bacterial species among pregnant women with asymptomatic bacteriuria. Materials and Methods:This study was conducted at 4 selected primary health care facilities in Harare, including pregnant women registering for antenatal care at gestation between 6 and 22 weeks and without urinary tract infection symptoms. Asymptomatic bacteriuria was diagnosed by culture test of all midstream urine samples following screening by Griess nitrate test. Susceptibility test was done for all positive 24 hour old culture using the disk diffusion test. The minimum inhibitory concentration was measured and categorized as susceptible, resistant and intermediate.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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2017

MOJI

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Screening for Asymptomatic Bacteriuria in Adults

Henderson

Webber

Bean

2019

JAMA

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Screening for Asymptomatic Bacteriuria in Adults

Owens

Davidson

Krist

et al. 2019

JAMA

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IMPORTANCE Among the general adult population, women (across all ages) have the highest prevalence of asymptomatic bacteriuria, although rates increase with age among both men and women. Asymptomatic bacteriuria is present in an estimated 1% to 6% of premenopausal women and an estimated 2% to 10% of pregnant women and is associated with pyelonephritis, one of the most common nonobstetric reasons for hospitalization in pregnant women. Among pregnant persons, pyelonephritis is associated with perinatal complications including septicemia, respiratory distress, low birth weight, and spontaneous preterm birth. OBJECTIVE To update its 2008 recommendation, the USPSTF commissioned a review of the evidence on potential benefits and harms of screening for and treatment of asymptomatic bacteriuria in adults, including pregnant persons. POPULATION This recommendation applies to community-dwelling adults 18 years and older and pregnant persons of any age without signs and symptoms of a urinary tract infection. EVIDENCE ASSESSMENT Based on a review of the evidence, the USPSTF concludes with moderate certainty that screening for and treatment of asymptomatic bacteriuria in pregnant persons has moderate net benefit in reducing perinatal complications. There is adequate evidence that pyelonephritis in pregnancy is associated with negative maternal outcomes and that treatment of screen-detected asymptomatic bacteriuria can reduce the incidence of pyelonephritis in pregnant persons. The USPSTF found adequate evidence of harms associated with treatment of asymptomatic bacteriuria (including adverse effects of antibiotic treatment and changes in the microbiome) to be at least small in magnitude. The USPSTF concludes with moderate certainty that screening for and treatment of asymptomatic bacteriuria in nonpregnant adults has no net benefit. The known harms associated with treatment include adverse effects of antibiotic use and changes to the microbiome. Based on these known harms, the USPSTF determined the overall harms to be at least small in this group. RECOMMENDATIONS The USPSTF recommends screening pregnant persons for asymptomatic bacteriuria using urine culture. (B recommendation) The USPSTF recommends against screening for asymptomatic bacteriuria in nonpregnant adults. (D recommendation)

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Antibiotics for asymptomatic bacteriuria in pregnancy

Cited by 318 publications

References 57 publications

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Screening for Asymptomatic Bacteriuria in Adults

Screening for Asymptomatic Bacteriuria in Adults

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