Pregnancy
- Definition of asymptomatic bacteriuria: two consecutive voided urine cultures with ≥ 108 cfu/L of same organism +/- pyuria, and NO symptoms of UTI.
- Asymptomatic bacteriuria with uropathogens in pregnant women should be treated as it is associated with increased incidence of pyelonephritis, preterm labour, and low birthweight infants.
- Screening for bacteriuria recommended at 12-16 weeks gestation, or first prenatal visit if later than 12-16 weeks gestation.
- Post treatment urine cultures recommended 1 week after completion of treatment followed by monthly urine cultures for remainder of pregnancy.
Usual Pathogens
E. coli
Other Enterobacterales
S. agalactiae (Group B Strep)
S. saprophyticus
Options in pregnancy based on C&S results
| Empiric Therapy | Dose | Duration |
|---|---|---|
| Amoxicillin | 500mg PO tid | 5 days |
| or | ||
| Cephalexin | 250-500mg PO qid | 5 days |
| or | ||
| Cefixime | 400mg PO daily | 5 days |
| or | ||
| Nitrofurantoin | Macrobid 100mg PO bid or 50-100mg PO qid | 5 days |
| or | ||
| TMP/SMX | 1 DS tab PO bid | 3 days |
| or | ||
| Trimethoprim | 100mg PO bid | 3 days |