Older adults with asymptomatic bacteriuria and patients with urinary catheters who do not have symptoms should not be treated with antibiotics. Unnecessary antibiotic use can lead to the urinary tract becoming colonized with more resistant or virulent bacteria.
Studies have shown that asymptomatic bacteriuria does not increase morbidity or mortality. Screening and treatment are only indicated before urological procedures that involve mucosal bleeding.
References:
- Helsedirektoratets retningslinjer for bruk av antibiotika:
- http://www.antibiotikaiallmennpraksis.no/
- https://helsedirektoratet.no/retningslinjer/antibiotika-i-sykehus
- Nicolle LE, Bradley S, Colgan R. Infectious Diseases Society of America Guidelines for the Diagnosis and Treatment of Asymptomatic Bacteriuria in Adults. Clin Infect Dis 2005;40:643-54
- Guidelines on Urological Infections, European Association Urology. https://uroweb.org/guideline/urological-infections/?type=pocket-guidelines
- Mody L, Juthani-Mehta M. Urinary tract infections in older women: a clinical review. JAMA 2014;311(8):844-54.
- Abrutyb E, et.al. Does asymptomatic bacteriuria predict mortality and does antimicrobial treatment reduce mortality in elderly ambulatory women? Ann Intern Med. 1994 May 15;120 (10):827-33.