Approach to a positive urine culture in a patient without urinary symptoms

Infect Dis Clin North Am. 2014 Mar;28(1):15-31. doi: 10.1016/j.idc.2013.09.005. Epub 2013 Dec 8.


Asymptomatic bacteriuria (ASB) is a condition in which bacteria are present in a noncontaminated urine sample collected from a patient without signs or symptoms related to the urinary tract. ASB must be distinguished from symptomatic urinary tract infection (UTI) by the absence of signs and symptoms compatible with UTI or by clinical determination that a nonurinary cause accounts for the patient's symptoms. The overall purpose of this review is to promote an awareness of ASB as a distinct condition from UTI and to empower clinicians to withhold antibiotics in situations in which antimicrobial treatment of bacteriuria is not indicated.

Keywords: Antibacterial agents; Asymptomatic bacteriuria; Guidelines implementation; Urinary tract infection.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Asymptomatic Infections / therapy*
  • Bacteriuria* / drug therapy
  • Bacteriuria* / epidemiology
  • Bacteriuria* / microbiology
  • Clinical Competence
  • Evidence-Based Medicine
  • Humans
  • Practice Guidelines as Topic
  • Prevalence
  • Risk Factors
  • United States / epidemiology
  • Withholding Treatment


  • Anti-Bacterial Agents