Asymptomatic
bacteriuria is a common finding, but is usually benign. Screening and treatment of asymptomatic
bacteriuria is only recommended for pregnant women, or for patients prior to selected invasive genitourinary procedures. Healthy women identified with asymptomatic
bacteriuria on population screening subsequently experience more frequent episodes of symptomatic
infection, but antimicrobial treatment of asymptomatic
bacteriuria does not decrease the occurrence of these episodes. Clinical trials in
spinal-cord injury patients, diabetic women, patients with indwelling
urethral catheters, and elderly
nursing home residents have consistently found no benefits with treatment of asymptomatic
bacteriuria. Negative outcomes with antimicrobial treatment do occur, including adverse drug effects and
re-infection with organisms of increasing resistance. Optimal management of asymptomatic
bacteriuria requires appropriate implementation of screening strategies to promote timely identification of the selected patients for whom treatment is beneficial, and avoidance of antimicrobial
therapy where no benefit has been shown.