Asymptomatic Bacteriuria

How to Cite This Chapter: Mertz D, Duława J, Drabczyk R. Asymptomatic Bacteriuria. McMaster Textbook of Internal Medicine. Kraków: Medycyna Praktyczna. Accessed July 08, 2020.
Last Updated: March 11, 2015
Last Reviewed: May 24, 2019
Chapter Information


Asymptomatic bacteriuria (ABU) is diagnosed when significant bacteriuria is detected in properly collected urine samples and is not accompanied by clinical signs or symptoms of urinary tract infection. Except for certain cases, ABU must not be treated with antibiotics, as the potential harm outweighs the potential benefits.Evidence 1Strong recommendation (downsides clearly outweigh benefits; right action for all or almost all patients). High Quality of Evidence (high confidence that we know true effects of the intervention). Cai T, Mazzoli S, Mondaini N, Meacci F, Nesi G, D'Elia C, Malossini G, Boddi V, Bartoletti R. The role of asymptomatic bacteriuria in young women with recurrent urinary tract infections: to treat or not to treat? Clin Infect Dis. 2012 Sep;55(6):771-7. doi: 10.1093/cid/cis534. Epub 2012 Jun 7. PubMed PMID: 22677710.


ABU requires no treatment, except for:

1) Pregnant patients (see Urinary Tract Infections in Pregnant Women).

2) Patients scheduled for urologic procedures when bleeding is anticipated, including transurethral resection of the prostate. In such individuals start antibacterial prophylaxis on the evening prior to the procedure using an antibiotic selected on the basis of culture results (preferably a fluoroquinolone) and continue only in case of delayed catheter removal.

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