Antibiotics for asymptomatic bacteriuria in pregnancy

The use of antibiotics to treat asymptomatic bacteriuria in pregnancy is efficacious and decreases the incidence of pyelonephritis in the women treated. Antibiotic therapy also appears to reduce the incidence of low-birth-weight and preterm babies. The duration of antibiotic therapy -either 3-7 days or continuously throughout pregnancy- had no effect on the outcomes studied. This review gives no indication antibiotic therapy has an impact on recurrence of bacteriuria later in pregnancy or in the postpartum period. The effectiveness of a strategy to re-culture urine upon completion of therapy and re-treatment of those still found to have asymptomatic bacteriuria was not evaluated in this review. A suggested association between anaemia and asymptomatic bacteriuria in pregnancy was not considered in the review as an outcome.

Of the 13 clinical trials included in this review, 11 were conducted between 1960 and 1975. Many of the included trials had methodological weaknesses, such as inadequate concealment of allocation, which could introduce bias. Not all of the antibiotics used in the studies included in the review are currently in use.

All adequately controlled trials, which could be identified, have been included and appropriately analysed.

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