Treatment of Asymptomatic Bacteriuria in Post-CABG Patients
Definition and Prevalence
- Asymptomatic bacteriuria is defined as the presence of bacteria in the urine without symptoms of urinary tract infection 1
Evidence Against Treatment in Non-Urologic Surgical Patients
- The Infectious Diseases Society of America (IDSA) guidelines strongly recommend against screening for or treating ASB in patients undergoing elective non-urologic surgery 4
- There is low-quality evidence that treating ASB before non-urologic procedures provides any benefit in preventing surgical site infections or other complications 4
- Treatment of ASB in post-surgical patients does not reduce the risk of symptomatic urinary tract infections and may promote antimicrobial resistance 4
Risks of Unnecessary Treatment
- Treatment of ASB promotes reinfection with organisms increasingly resistant to antimicrobials 5
- Antimicrobial therapy has an important risk of adverse effects including Clostridioides difficile infection 5
When to Consider Treatment of Bacteriuria
- Treatment is only indicated when patients develop symptoms of urinary tract infection 1, 2, 3
- Before urologic procedures that breach the mucosal lining, ASB should be treated to prevent infectious complications 6, 7
- Symptoms that would warrant treatment include dysuria, frequency, urgency, suprapubic pain, or fever with no other identified source 1