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Asymptomatic Bacteriuria: Prevalence, Diagnosis, Management, and Current Antimicrobial Stewardship Implementations
Tyler Luu1, Fritzie S Albarillo2
1Department of Medicine.
The American Journal of Medicine
|April 3, 2022
Summary
Asymptomatic bacteriuria, common in older women, rarely requires antibiotics and often leads to unnecessary treatment. Current guidelines emphasize screening and treating only in specific cases like pregnancy or before urologic procedures.
Area of Science:
- Clinical Medicine
- Infectious Diseases
- Geriatrics
Background:
- Asymptomatic bacteriuria (ASB) is common, particularly in older women, with incidence rates exceeding 15% and reaching 50% in long-term care facilities.
- ASB frequently leads to unnecessary antibiotic prescriptions, despite evidence suggesting it does not improve patient outcomes in most cases.
Purpose of the Study:
- To review the current understanding and management guidelines for asymptomatic bacteriuria.
- To highlight the risks associated with unnecessary antibiotic treatment for ASB.
Main Methods:
- Review of the 2019 Infectious Disease Society of America (IDSA) guidelines for ASB management.
- Analysis of evidence regarding the benefits and risks of treating ASB in various patient populations.
Main Results:
- Antibiotic treatment of ASB has not been shown to improve clinical outcomes in most individuals, including those with diabetes, spinal cord injuries, or indwelling catheters.
- Specific populations, such as pregnant women and individuals undergoing urologic procedures, benefit from ASB screening and treatment.
- Unnecessary treatment contributes to antimicrobial resistance, Clostridioides difficile infections, and increased healthcare costs.
Conclusions:
- Antibiotic stewardship programs are crucial for reducing the overtreatment of ASB.
- ASB should only be treated when there is clear evidence of potential clinical benefit, adhering to updated guidelines.
Keywords:
Antibiotic stewardshipAsymptomatic bacteriuriaDiagnosisScreeningTreatmentUrinary tract infectionMore Related Videos
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