Infectious Diseases Society of America guidelines for the diagnosis and treatment of …

Infectious Diseases Society of America; American Society of Nephrology; American Geriatric Society. Infectious Diseases Society of America guidelines for the diagnosis and treatment of asymptomatic bacteriuria in adults. Clin Infect Dis. 2005 Mar 1;40(5):643-54

The purpose of this guideline is to provide recommendationsfor diagnosis and treatment of asymptomatic bacteriuria inadult populations118 years of age. The recommendations weredeveloped on the basis of a review of published evidence, withthe strength of the recommendation and quality of the evidencegraded using previously described Infectious Diseases Societyof America (IDSA) criteria (table 1) [1]. Recommendations arerelevant only for the treatment of asymptomatic bacteriuria anddo not address prophylaxis for prevention of symptomatic orasymptomatic urinary infection. This guideline is not meantto replace clinical judgment.

Screening of asymptomatic subjects for bacteriuria is appro-priate if bacteriuria has adverse outcomes that can be preventedby antimicrobial therapy [2]. Outcomes of interest are shortterm, such as symptomatic urinary infection (including bac-teremia with sepsis or worsening functional status), and longerterm, such as progression to chronic kidney disease or hyper-tension, development of urinary tract cancer, or decreased du-ration of survival. Treatment of asymptomatic bacteriuria mayitself be associated with undesirable outcomes, including sub-sequent antimicrobial resistance, adverse drug effects, and cost.If treatment of bacteriuria is not beneficial, screening of asymp-tomatic populations to identify bacteriuria is not indicated,unless performed in a research study to further explore thebiology or clinical significance of bacteriuria. Thus, there are2 topics of interest: whether asymptomatic bacteriuria is as-sociated with adverse outcomes, and whether the interventionsof screening and antimicrobial treatment improve theseoutcomes.

Disponível Em: <https://www.ncbi.nlm.nih.gov/>