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Asymptomatic bacteriuria. Which patients should be treated?

G G Zhanel1, G K Harding, D R Guay

  • 1Department of Medical Microbiology, University of Manitoba, Winnipeg, Canada.

Archives of Internal Medicine
|July 1, 1990
PubMed
Summary

Treatment for asymptomatic bacteriuria (bacteria in urine without symptoms) varies by patient group. While recommended for infants, children, pregnant women, and certain adults with urinary abnormalities, it

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Area of Science:

  • Urology
  • Infectious Diseases
  • Public Health

Background:

  • Asymptomatic bacteriuria (ABU) is prevalent in community and healthcare settings.
  • Limited data exist on ABU complications across diverse patient groups and conditions.
  • Evidence gaps hinder standardized treatment guidelines for ABU.

Purpose of the Study:

  • To review and synthesize current literature on ABU.
  • To provide evidence-based recommendations for ABU treatment.
  • To identify patient populations benefiting from ABU treatment.

Main Methods:

  • Literature review of studies on asymptomatic bacteriuria.
  • Analysis of ABU complications and treatment outcomes.
  • Synthesis of data to formulate treatment guidelines.

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Main Results:

  • Treatment is recommended for neonates, preschool children, and pregnant women with ABU.
  • Antimicrobial therapy is advised for patients with abnormal urinary tracts or undergoing specific procedures.
  • Routine treatment is not indicated for school-age children, nonpregnant women, or elderly individuals with normal urinary tracts.

Conclusions:

  • ABU treatment decisions should be individualized based on patient demographics and clinical factors.
  • Further research is needed to clarify ABU management in controversial cases, such as those with short-term catheters or ileal conduits.
  • Current recommendations aim to optimize outcomes and prevent complications while avoiding unnecessary antimicrobial use.