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Evidence summaries

Duration of Antibiotic Treatment in Asymptomatic Bacteriuria in Pregnancy

Single-dose treatment may be less effective than a 4-7 day course in the treatment of asymptomatic bacteriuria in pregnancy. Level of evidence: "C"

A Cochrane review [Abstract] 1 included 13 studies with a total of 1622 women. 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 (RR 1.33, 95% CI 0.88 to 2.01; 12 trials, n=1502) although this difference was non-statistically significant. There was almost no difference in the recurrence of asymptomatic bacteriuria rate between both treatments (RR 1.09, 95% CI 0.75 to 1.60; 8 trials, n=245). 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).

Comment: The quality of evidence is downgraded by inconsistency (variability of results across studies) and imprecise results.

References

  • Widmer M, Lopez I, Gülmezoglu AM et al. Duration of treatment for asymptomatic bacteriuria during pregnancy. Cochrane Database Syst Rev 2015;(11):CD000491. [PubMed]

Primary/Secondary Keywords