Takaisin Tulosta

Antibiotics vs. no treatment for asymptomatic bacteriuria in pregnancy

Evidence summaries
7.12.2019 • Latest change 7.12.2019
Editors

Level of evidence: B

Antibiotic treatment appears to reduce the risk of pyelonephritis in pregnancy and appears to reduce the incidence of preterm delivery and low birthweight babies compared to placebo or no treatment.

A Cochrane review «Antibiotics for asymptomatic bacteriuria in pregnancy»1 «Smaill FM, Vazquez JC. Antibiotics for asymptomatic bacteriuria in pregnancy. Cochrane Database Syst Rev 2019;2019(11):. »1 included 15 studies with over 2000 women. Antibiotic treatment compared to placebo or no treatment was effective in clearing asymptomatic bacteriuria. The incidence of pyelonephritis, preterm delivery, and low birthweight babies was reduced (table «Antibiotics for asymptomatic bacteriuria in pregnancy»1). There were very limited data on which to estimate the effect of antibiotics on other infant outcomes, and maternal adverse effects were rarely described.

Table 1. Antibiotics for asymptomatic bacteriuria in pregnancy
OutcomeRelative effect (95% CI)Risk with no treatment Risk with antibiotics (95% CI)№ of participants (studies) Certainty of the evidence
Development of pyelonephritis RR 0.24 (0.13 to 0.41) 199 per 1000 48 per 1000 (26 to 82)2017 (12) Low
Preterm birth < 37 weeks RR 0.34 (0.13 to 0.88) 174 per 1000 59 per 1000 (23 to 153)327 (3) Low
Birthweight < 2500 g RR 0.64 (0.45 to 0.93)136 per 1000 87 per 1000 (61 to 126)1437 (6) Low

Comment: The quality of evidence was downgraded by severe limitations in study quality (high or unclear risk of bias in most studies).

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References

  1. Smaill FM, Vazquez JC. Antibiotics for asymptomatic bacteriuria in pregnancy. Cochrane Database Syst Rev 2019;2019(11):. «PMID: 31765489»PubMed