Appropriate Treatment for Asymptomatic Bacteriuria

Segment description: Barbara Wells Trautner, MD, PhD, associate professor and director of clinical research at Baylor College of Medicine, explains the difference between asymptomatic bacteriuria and urinary tract infections.

Interview transcript (modified slightly for readability):

I like words, so you have to take the medical words apart and understand what they mean. Bacteriuria is bacteria in the urine and it can be 1 of 2 things; it can be asymptomatic bacteriuria, or it can be a urinary tract infection (UTI) and the difference between the 2 is the presence of symptoms that are related to bacteria in the urinary tract. It’s not just symptoms, all of us have some symptoms; you can have a stuffy nose 1 day but that’s not related to your urinary tract. So, asymptomatic bacteriuria is the presence of bacteria in the urine without symptoms related to the urinary tract, and UTI is bacteria in the urine with symptoms related to the urinary tract. You treat UTI to relive symptoms; you do not treat asymptomatic bacteria because they do not have urinary symptoms.

You only treat it in 2 populations and that is pregnant women and people who are about to undergo urologic surgery that can cause significant mucosal bleeding. In other groups, screening for and treatment of asymptomatic bacteria is not helpful and may even be harmful because of increased antibiotic use.