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Clinical Practice Guideline for the Management of Asymptomatic Bacteriuria: 2019 Update by the Infectious Diseases

Lindsay E Nicolle1, Kalpana Gupta2, Suzanne F Bradley3

  • 1Department of Internal Medicine, School of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|March 22, 2019
PubMed

Insights

Asymptomatic bacteriuria (ASB) screening and treatment guidelines are updated. New recommendations address previously unaddressed populations and the risks of antimicrobial resistance from treating ASB.

Area of Science:

  • Infectious Diseases
  • Urology
  • Antimicrobial Stewardship

Background:

  • Asymptomatic bacteriuria (ASB) is common, but treatment recommendations have been limited.
  • The 2005 guideline advised ASB treatment only for pregnant women or before urologic procedures.
  • Concerns about antimicrobial resistance have grown due to inappropriate ASB treatment.

Purpose of the Study:

  • To update the 2005 Infectious Diseases Society of America (IDSA) guideline on ASB.
  • To provide recommendations for populations not covered in the previous guideline.
  • To address the interpretation of symptoms in high-ASB prevalence groups.

Main Methods:

  • Systematic review of recent scientific literature on ASB.
  • Expert panel consensus development.
  • Incorporation of new data on antimicrobial resistance and treatment outcomes.

Main Results:

  • Updated recommendations for screening and treating ASB in various populations.
  • Specific guidance for children, neutropenic patients, transplant recipients, and others.
  • Emphasis on judicious antimicrobial use to combat resistance.

Conclusions:

  • The updated guideline refines ASB management strategies.
  • It aims to optimize patient care while minimizing the contribution of ASB treatment to antimicrobial resistance.
  • New recommendations provide a framework for evidence-based ASB management in diverse clinical scenarios.

Keywords:
asymptomatic bacteriuriabacteriuriacystitisdiabetesendourologic surgerylong-term careneurogenic bladdernursing homeolder adultspregnancypyelonephritisrenal transplantspinal cord injuryurinary catheterurinary tract infectionurologic devices

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