Asymptomatic bacteriuria and symptomatic urinary tract infections in pregnancy

Eur J Clin Invest. 2008 Oct;38 Suppl 2:50-7. doi: 10.1111/j.1365-2362.2008.02009.x.

Abstract

Symptomatic and asymptomatic bacteriuria is common in pregnant women. A history of previous urinary tract infections and low socioeconomic status are risk factors for bacteriuria in pregnancy. Escherichia coli is the most common aetiologic agent in both symptomatic and asymptomatic infection and quantitative culture is the gold standard for diagnosis. Treatment of asymptomatic bacteriuria has been shown to reduce the rate of pyelonephritis in pregnancy and therefore screening for and treatment of asymptomatic bacteriuria has become a standard of obstetrical care. Antibiotic treatment of asymptomatic bacteriuria is associated with a decrease in the incidence of low birth weight, but the methodological quality of the studies limits the strength of the conclusions that can be drawn. Debate exists in the literature as to whether treated pyelonephritis is associated with adverse fetal outcomes. There is no clear consensus in the literature on antibiotic choice or duration of therapy for infection. With increasing antibiotic resistance, consideration of local resistance rates is necessary when choosing therapy.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Anti-Infective Agents, Urinary / therapeutic use*
  • Bacteriuria / diagnosis*
  • Bacteriuria / drug therapy
  • Cystitis / diagnosis
  • Cystitis / drug therapy
  • Female
  • Humans
  • Pregnancy
  • Pregnancy Complications, Infectious / diagnosis*
  • Pregnancy Complications, Infectious / drug therapy
  • Urinary Tract Infections / diagnosis*
  • Urinary Tract Infections / drug therapy

Substances

  • Anti-Bacterial Agents
  • Anti-Infective Agents, Urinary