Bacteriuria in pregnant patients

Dr Mark Loeb is a professor in the Department of Pathology and Molecular Medicine, division director for Infectious Diseases, and Michael G. DeGroote Chair in Infectious Diseases at McMaster University.

What is the recommended treatment for bacteriuria in a pregnant woman?

Mark Loeb, MD, MSc: There are different agents that are potentially available— nitrofurantoin, trimethoprim/sulfamethoxazole, beta-lactams—but it’s really important to know the patient and where they are in their pregnancy.

At the very beginning of the pregnancy we would try to avoid using nitrofurantoin and trimethoprim/sulfamethoxazole. At the very end, during the last few days of pregnancy, we would actually avoid using trimethoprim/sulfamethoxazole. You have to know about the patient. If it’s asymptomatic bacteriuria, you can actually get the organism and you have some time to decide.