Asbtract
Asymptomatic bacteriuria is a common clinical condition that often leads to unnecessary
treatment. It has been shown that incidence of asymptomatic bacteriuria increases
with age and are more prominent in women than men. In older women, the incidence of
asymptomatic bacteriuria is recorded to be more than 15%. This number increased up
to 50% for those who reside in long-term care facilities. In most scenarios, asymptomatic
bacteriuria does not lead to urinary tract infections, and therefore, antibiotic treatment
of asymptomatic bacteriuria has not been shown to improve patient outcomes. In 2019,
the Infectious Disease Society of America (IDSA) updated its asymptomatic bacteriuria
management guidelines, which emphasized on the risks and benefits of treating the
condition. Women who are pregnant should be screened for asymptomatic bacteriuria
in the first trimester and treated, if positive. Individuals who are undergoing endoscopic
urologic procedures should be screened and treated appropriately for asymptomatic
bacteriuria as well. Treating asymptomatic bacteriuria in individuals with diabetes,
neutropenia, spinal cord injuries, indwelling urinary catheters, and so on has not
been found to improve clinical outcomes. Furthermore, unnecessary treatment is often
associated with unwanted consequences including but not limited to increased antimicrobial
resistance, Clostridioides difficile infection, and increased health care cost. As a result, multiple antibiotic stewardship
programs around the US have implemented protocols to appropriately reduce unnecessary
treatment of asymptomatic bacteriuria. It is important to appropriately screen and
treat asymptomatic bacteriuria only when there is evidence of potential benefit.
Keywords
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Article Info
Publication History
Published online: March 31, 2022
Footnotes
Funding: None.
Conflicts of Interest: None.
Authorship: Both authors had access to the data and a role in writing this manuscript.
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