Management of asymptomatic bacteriuria: When to screen and when to treat?

Colin Hannesse, Halil Yildiz, Jean Cyr Yombi Published in the journal : April 2021 Category : Internal Medicine

Summary :

Asymptomatic bacteriuria is defined as the presence of bacteria in the urine without any symptoms. It is very common, especially in the elderly. Despite clear national and international clinical guidelines, asymptomatic bacteriuria is far too often associated with screening and treatment. This strategy proves to be costly and promotes bacterial resistance, while exposing patients to the numerous undesirable effects of antibiotics. Unless specific urinary tract symptoms are present, a urine culture is only required for pregnant women, recent kidney transplant recipients (< 1 month), and prior to any urological procedures that likely cause mucous bleeding. For elderly patients with or without cognitive impairment who haven fallen or are confused, presenting with an otherwise asymptomatic bacteriuria, all infectious etiologies other than urinary causes must first be excluded before initiating any antibiotic therapy.

What do we know about the topic?

Screening for bacteriuria is very common, yet it is not advised in many patients as long as symptoms are lacking. Most often, it is followed by an unjustified antibiotic prescription. 

What does this article bring up for us?

A short and practical indication as to when screening and treatment should be initiated in case of bacteriuria occurring in an asymptomatic patient is being provided.

Key Words

Asymptomatic bacteriuria, urinary tract infections