Treatment of Asymptomatic Bacteriuria in Pregnancy
Treatment of Asymptomatic Bacteriuria in Pregnancy
This is a prospective randomized controlled day comparing the efficacy of three-day
 antimicrobial treatment of asymptomatic bacteriuria (ASB) in pregnancy to the standard
 seven-day treatment. Half the patients will receive 3-day treatment and the other half will
 receive 7 days of antibiotics.
The current standard of practice is to treat pregnant patients with ASB with a 7-day course
 of oral antimicrobial agents. If bacteriuria persists women are retreated with the same of
 different agent for a second course of 7 to 14 days and they may be subsequently placed on
 prophylaxis.

 In nonpregnant women, an uncomplicated lower urinary tract infection may be treated with a
 short course regimen from 1 to 3 days. This approach has similar rates of persistent
 bacteriuria or symptoms following treatment when compared to women treated with a more
 conventional approach. If the infection recurs or persists, the patient may then be treated
 with the more traditional 7 to 14 day course. The advantages of single-dose regimens are cost
 and patient compliance, but a major disadvantage is the failure to eradicate uropathogens
 from the vaginal reservoir, which results in more frequent early recurrences.

 The three-day regimen is advocated to maintain the advantages of lower costs and patient
 compliance but improving cure rates. Multiple studies have shown the advantage of even a
 short course of antibiotics as opposed to no treatment.
Inclusion Criteria:

 -  Pregnant women ≥ 18 years of age seeking prenatal care at the Academic Obstetrics and
 Gynecology Center at St. Joseph Mercy Hospital, Ann Arbor, Michigan

 -  Randomization will occur if the patient every has a urine culture demonstrating
 ≥10,000 cfu/ml of a pathogenic urinary tract organism

 Exclusion Criteria:

 -  Symptomatic bacteriuria (cystitis or pyelonephritis) at the time of urine collection

 -  Previously treated bacteriuria in current pregnancy

 -  Past medical history of known congenital or acquired urinary tract anomaly or
 abnormality (i.e. pelvic kidney, single kidney, renal transplant)

 -  Any antibiotic use within the week prior to urine sampling

 -  Urine culture revealing growth of the following organisms: Lactobacillus,
 coagulase-negative staphylococcus