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Duration of treatment for asymptomatic bacteriuria during pregnancyVillar J, Widmer M, Lydon-Rochelle M, Gülmezoglu AM, Roganti A
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SummaryDuration of treatment for asymptomatic bacteriuria during pregnancyNot enough evidence to show if single-dose antibiotics are as effective as longer courses of treatment for asymptomatic bacteriuria in pregnancy. Asymptomatic bacteriuria is a urinary tract infection (without symptoms) common in pregnancy. If untreated, it can lead to pyelonephritis. Antibiotic treatment is recommended. This review aimed to identify whether single-dose antibiotic treatments are as effective as standard longer ones for maternal and newborn outcomes. There was not conclusive evidence from trials to answer this question. The new ongoing WHO trial will provide a definite answer to it by the year 2007. Despite longer treatments resulting in more moderate adverse effects (nausea, vomiting, diarrhoea), it is recommended to follow standard treatment regimen for asymptomatic bacteriuria in pregnant women.
This is a Cochrane review abstract and plain language summary, prepared and maintained by The Cochrane Collaboration, currently published in The Cochrane Database of Systematic Reviews 2010 Issue 1, Copyright © 2010 The Cochrane Collaboration. Published by John Wiley and Sons, Ltd.. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).
This version first published online:
January 26. 1998 AbstractBackgroundA Cochrane systematic review has shown that drug treatment of asymptomatic bacteriuria in pregnant women substantially decreases the risk of pyelonephritis and reduces the risk of preterm delivery. However, it is not clear whether single-dose therapy is as effective as longer conventional antibiotic treatment. ObjectivesTo assess the effects of different durations of treatment for asymptomatic bacteriuria in pregnancy. Search strategyWe searched the Cochrane Pregnancy and Childbirth Group's Trials Register (July 2006) and reference lists of identified articles. Selection criteriaRandomized and quasi-randomized trials comparing antimicrobial therapeutic regimens that differed in duration (particularly comparing single dose with longer duration regimens) in pregnant women diagnosed with asymptomatic bacteriuria. Data collection and analysisWe assessed trial quality and extracted data independently. Main resultsTen studies, involving over 568 women, were included. All were comparisons of single-dose treatment with four- to seven-day treatments. The trials were generally of limited quality. The 'no cure rate' for asymptomatic bacteriuria in pregnant women was higher for one-day treatment than for seven-day treatment (relative risk (RR) 1.25, 95% confidence interval (CI) 0.93 to 1.67) although this difference was non-statistically significant. These results showed significant heterogeneity (P = 0.006). There was almost no difference in the recurrence of asymptomatic bacteriuria rate between both treatments (RR 1.14, 95% CI 0.77 to 1.67). No differences were detected for preterm births and pyelonephritis although sample size of trials was not appropriate. Single-dose treatment was associated with a decrease in reports of 'any side-effects' (nausea, vomiting, diarrhoea) (RR 0.52, 95% CI 0.32 to 0.85). Authors' conclusionsThere is not enough evidence to evaluate whether single dose or longer duration doses are equivalent in treating asymptomatic bacteriuria in pregnant women. Because single-dose treatment has lower cost and increased compliance, this comparison should be explored in a properly sized, randomized controlled trial. WHO is currently conducting such a trial and the results will be available in 2007. |