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Related Experiment Video

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The ITS2 Database
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[Bacteriuria. Cochrane Database Syst Rev. 2015;4:CD009534.]

Miguel Bigotte Vieira1, Mariana Alves2, João Costa3

  • 1Co-primeiro autor; Serviço de Nefrologia e Transplantação Renal. Centro Hospitalar Lisboa Norte. Lisboa. Portugal.

Acta Medica Portuguesa
|March 30, 2018
PubMed
Summary

Treating asymptomatic bacteriuria (bacteria in urine without symptoms) in adults offers no clinical benefit. Antibiotic treatment did not reduce symptomatic urinary tract infections, complications, or death, but increased adverse events.

Keywords:
AdultAnti-Bacterial AgentsAsymptomatic InfectionsBacteriuriaRandomized Controlled Trials as Topic

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Area of Science:

  • Urology
  • Infectious Diseases
  • Evidence-Based Medicine

Background:

  • Asymptomatic bacteriuria is common in women, diabetics, and the elderly.
  • The clinical benefit of antibiotic treatment for asymptomatic bacteriuria remains controversial.

Purpose of the Study:

  • To systematically review the effectiveness and safety of antibiotic treatment for asymptomatic bacteriuria in adults.

Main Methods:

  • Systematic review of randomized controlled trials (RCTs) and quasirandomised controlled trials.
  • Searched literature up to February 24, 2015, via Cochrane Renal Group's Specialised Register.
  • Included studies comparing antibiotics to placebo or no treatment, assessing various clinical outcomes.

Main Results:

  • Nine studies with 1614 participants were analyzed.
  • No significant difference in symptomatic urinary tract infections, complications, or death between antibiotic and control groups.
  • Antibiotic use led to bacteriological cure and increased minor adverse events, with no observed decline in kidney function.

Conclusions:

  • Current evidence suggests no clinical benefit in treating asymptomatic bacteriuria in adults.
  • Antibiotic treatment does not prevent symptomatic infections or complications and is associated with increased adverse events.