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Screening and treating asymptomatic bacteriuria in pregnancy.
Pisake Lumbiganon1, Malinee Laopaiboon, Jadsada Thinkhamrop
1Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand. pisake@kku.ac.th
Current Opinion in Obstetrics & Gynecology
|February 9, 2010
Summary
Asymptomatic bacteriuria (ASB) in pregnancy can be effectively screened using dipslide tests. Treatment with a seven-day antibiotic regimen improves cure rates, though shorter courses may suffice in some cases.
Area of Science:
- Obstetrics and Gynecology
- Infectious Diseases
- Clinical Microbiology
Background:
- Asymptomatic bacteriuria (ASB) in pregnancy poses risks, including maternal pyelonephritis and low infant birth weight.
- Urine culture, the gold standard for ASB diagnosis, has limited availability.
- Effective screening and treatment are crucial for managing ASB in pregnant individuals.
Purpose of the Study:
- To evaluate the performance of various screening tests for ASB in pregnancy.
- To assess the effectiveness of different antibiotic regimens for treating ASB.
Main Methods:
- Review of available evidence on screening tests for ASB.
- Analysis of antibiotic treatment regimens and their outcomes.
- Comparison of dipslide tests, urine dipsticks, and urine cultures.
Main Results:
- Dipslide tests demonstrate high accuracy for ASB screening; a positive result strongly suggests ASB, and a negative result effectively rules it out.
- Urine dipstick performance is conflicting, making it currently unsuitable for ASB screening in pregnancy.
- Nitrofurantoin is recommended as the antibiotic of choice, guided by susceptibility testing.
- A 7-day antibiotic regimen offers better microbiological cure rates than a 1-day regimen, with no significant difference in clinical outcomes.
Conclusions:
- Dipslide culture is a promising screening tool for ASB in pregnancy.
- A 7-day antibiotic regimen is preferred for treating ASB, though 1-day regimens may be considered.
- Further research is needed to identify optimal screening methods for ASB.
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