scholarly journals Análise da Revisão Cochrane: Antibióticos Destinados ao Tratamento da Bacteriúria Assintomática. Cochrane Database Syst Rev. 2015;4:CD009534.

2018 ◽  
Vol 31 (2) ◽  
pp. 76
Author(s):  
Miguel Bigotte Vieira ◽  
Mariana Alves ◽  
João Costa ◽  
António Vaz-Carneiro
Keyword(s):  
Systematic Review ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Adverse Events ◽  
Kidney Function ◽  
Antibiotic Treatment ◽  
Asymptomatic Bacteriuria ◽  
Controlled Trials ◽  
Symptomatic Urinary Tract Infection

Asymptomatic bacteriuria is frequently detected in women aged up to 60 years, patients with diabetes and elderly patients. The benefit of antibiotic treatment for this condition is controversial. The objective of this Cochrane systematic review was to assess the effectiveness and safety of antibiotic treatment for asymptomatic bacteriuria in adults. A systematic review of the literature up to 24 February 2015 was performed using the Cochrane Renal Group’s Specialised Register. Randomised controlled trials (RCTs) and quasirandomised controlled trials comparing antibiotics to placebo or no treatment for asymptomatic bacteriuria in adults were included. The outcomes of interest were the development of symptomatic urinary tract infection, complications, death, adverse events, development of antibiotic resistance, bacteriological cure, and decline in kidney function. Nine studies (1614 participants) were included in this review. The incidence of symptomatic urinary tract infection, complications or death was similar between groups. Antibiotic use was significantly associated with bacteriological cure and an increase in minor adverse events. No decline in kidney function was observed with any one of the treatments. According to the results of the studies included in this revision, authors have concluded that there is no clinical benefit in treating asymptomatic bacteriuria in adults.

scholarly journals Maternofetal outcome in early versus late detected asymptomatic bacteriuria of pregnancy

2017 ◽  
Vol 7 (1) ◽  
pp. 80
Author(s):  
Indira Guntoory ◽  
Poornima Penmetsa ◽  
Sarath B. Rayapu ◽  
Nambaru R. Nambaru
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Pregnant Women ◽  
Asymptomatic Bacteriuria ◽  
P Value ◽  
Negative Group ◽  
Symptomatic Urinary Tract Infection ◽  
Foetal Outcome ◽  
In Pregnancy

Background: Urinary tract infection in pregnancy is a problem of global significance. Untreated asymptomatic bacteriuria in pregnancy is known to be associated with maternal and foetal outcome in the form of symptomatic urinary tract infection (UTI), acute pyelonephritis, anaemia, pregnancy induced hypertension (PIH), preterm labour (PTL), low birth weight (LBW), intrauterine growth restriction (IUGR) and prematurity. This study is aimed to compare the maternal and foetal outcome of pregnant women with bacteriuria with that of women without bacteriuria and also to see if screening later in pregnancy at 28-37 weeks of gestation is as effective as screening at less than 20 weeks of pregnancy in terms of maternofoetal outcome.Methods: 165 pregnant women attending the antenatal clinic at MIMS, Nellimerla, Vizianagaram district, Andhra Pradesh, India were screened for asymptomatic bacteriuria by urine culture and sensitivity. They were grouped into asymptomatic bacteriuria negative and culture positive groups. Culture positives were further grouped as early detected and late detected group based on the gestational age at sampling. They were followed up till delivery. The maternofoetal outcome was compared between different groups by computing Odd’s ratio and P value of less than 0.05 was taken as significant.Results: There was no statistically significant increase in adverse maternofoetal outcome between early detected and bacteriuria negative group. The women of late detected group had greater odds of developing symptomatic UTI, PIH, PTL, LBW, IUGR and neonatal intensive care unit admissions when compared to early detected and bacteriuria negative group which was statistically significant.Conclusions: Screening for asymptomatic bacteriuria early in pregnancy at less than 20 weeks is more effective in reducing the adverse maternofoetal outcome.

scholarly journals Positive Urine Cultures: A Major Cause of Inappropriate Antimicrobial Use in Hospitals?

2009 ◽  
Vol 20 (4) ◽  
pp. 107-111 ◽  
Author(s):  
Samuel A Silver ◽  
Laura Baillie ◽  
Andrew E Simor
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Medical Records ◽  
Urine Culture ◽  
Asymptomatic Bacteriuria ◽  
Antimicrobial Use ◽  
Symptomatic Urinary Tract Infection ◽  
Positive Urine ◽  
Urine Specimens

INTRODUCTION: Urine specimens are among the most common samples submitted for culture to microbiology laboratories. The objectives of the present study were to describe the indications for obtaining urine cultures in a cohort of hospitalized patients, and to determine the appropriateness of antimicrobial therapy in response to urine culture results.METHODS: The study was performed at a teaching hospital with an adjoining long-term care facility from June 1 to July 31, 2006. The medical records of nonpregnant adult patients with and without bacteriuria were reviewed. A symptomatic urinary tract infection was defined as the presence of bacteriuria in a patient with fever or urinary symptoms; asymptomatic bacteriuria was defined as bacteriuria without urinary symptoms and no infection evident at another site.RESULTS: Medical records of 335 eligible patients (64% male; mean age 68 years) were reviewed, including all 137 with bacteriuria, and 198 with negative urine cultures. In total, 51% of the urine specimens were obtained from an indwelling urinary catheter, and 28% were voided urine samples. Confusion (57%) and fever (36%) were the most common indications noted for obtaining the urine cultures. Only 34 patients (25% of those with positive urine cultures) met the criteria for a symptomatic urinary tract infection; 67 (49%) had asymptomatic bacteriuria and 36 (26%) had infection at a nonurinary site. Of those with asymptomatic bacteriuria, 64% received antimicrobial therapy for a total of 347 days. Confused patients with asymptomatic bacteriuria were more likely to be treated than were bacteriuric patients without altered mental status (OR 1.8, 95% CI 1.2 to 4.1; P=0.03).CONCLUSIONS: Urine cultures are frequently obtained from hospitalizedpatients,evenintheabsenceofurinarysymptoms.Asymptomatic bacteriuria is often treated in these patients, and accounts for a substantial burden of inappropriate antimicrobial use in hospitals. Effective strategies to improve urine culture ordering and antimicrobial utilization in hospitals need to be implemented.

scholarly journals Diagnosis, Prevention, and Treatment of Catheter-Associated Urinary Tract Infection in Adults: 2009 International Clinical Practice Guidelines from the Infectious Diseases Society of America

2010 ◽  
Vol 50 (5) ◽  
pp. 625-663 ◽  
Author(s):  
Thomas M. Hooton ◽  
Suzanne F. Bradley ◽  
Diana D. Cardenas ◽  
Richard Colgan ◽  
Suzanne E. Geerlings ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Infectious Diseases ◽  
Management Strategies ◽  
Asymptomatic Bacteriuria ◽  
Direct Patient Care ◽  
Term Care ◽  
Medical Specialties ◽  
Symptomatic Urinary Tract Infection

Abstract Guidelines for the diagnosis, prevention, and management of persons with catheter-associated urinary tract infection (CA-UTI), both symptomatic and asymptomatic, were prepared by an Expert Panel of the Infectious Diseases Society of America. The evidence-based guidelines encompass diagnostic criteria, strategies to reduce the risk of CA-UTIs, strategies that have not been found to reduce the incidence of urinary infections, and management strategies for patients with catheter-associated asymptomatic bacteriuria or symptomatic urinary tract infection. These guidelines are intended for use by physicians in all medical specialties who perform direct patient care, with an emphasis on the care of patients in hospitals and long-term care facilities.

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