ASB guideline expanded to include children, more adult populations

  • Nicolle LE & al.
  • Clin Infect Dis
  • 21 Mar 2019

  • International Clinical Digest
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Takeaway

  • A 2019 update to the Infectious Diseases Society’s clinical practice guideline for managing asymptomatic bacteriuria (ASB) contains new recommendations for both children and more adult populations.

Why this matters

  • The researchers say that since publication of the 2005 version, antimicrobial stewardship programs have identified nontreatment of ASB as a path to decreasing inappropriate antimicrobial use.

Key recommendations

  • The updated guideline recommends against ASB screening and treatment for the following groups:
    • infants and children,
    • healthy premenopausal, nonpregnant women, or healthy postmenopausal women,
    • older, community-dwelling persons who are functionally impaired,
    • older persons residing in long-term care facilities,
    • patients with diabetes,
    • patients who have had renal transplant surgery >1 month prior,
    • patients with nonrenal solid organ transplant,
    • patients with spinal cord injury,
    • patients with a short-term indwelling urethral catheter (
    • patients with long-term indwelling catheters,
    • patients undergoing elective nonurologic surgery,
    • patients planning to undergo surgery for an artificial urine sphincter or penile prosthesis implantation, and
    • patients living with implanted urologic devices.
  • Patients who should be screened and treated include:
    • pregnant women, and
    • patients who will undergo endoscopic urologic procedures.

Limitations

  • The guideline makes no recommendation for patients with high-risk neutropenia or patients with indwelling catheters at the time of catheter removal.