Choosing Wisely Recommendations
Avoid the use of surveillance cultures for the screening and treatment of asymptomatic bacteruria.
Rationale and Comments
There is minimal evidence that surveillance urine cultures or treatment of asymptomatic bacteruria is beneficial. Surveillance cultures are costly and produce both false-positive and false-negative results. Treatment of asymptomatic bacteruria also increases exposure to antibiotics, which is a risk factor for subsequent infections with a resistant organism. This also results in the overall use of antibiotics in the community and may lead to unnecessary imaging.
Sponsoring Organizations
- American Academy of Pediatrics
Sources
- American Academy of Pediatrics guidelines
Disciplines
References
- Conway PH, Cnaan A, Zaoutis T, Henry BV, Grundmeier RW, Keren R. Recurrent urinary tract infections in children: risk factors and association with prophylactic antimicrobials. JAMA. 2007 Jul 11;298(2):179–86.
- Kemper KJ, Avner ED. The case against screening urinalysis for asymptomatic bacteruria in children. Am J Dis Child. 1992 Mar;146(3):343–6.
- Nicolle LE. Asymptomatic bacteruria: when to screen and when to treat. Infect Dis Clin North Am. 2003 Jun;17(2):367–94.
- Roberts KB; American Academy of Pediatrics Subcommittee on Urinary Tract Infection, Steering Committee on Quality Improvement and Management. Urinary tract infection: clinical practice guideline for the diagnosis and management of the initial UTI in febrile infants and children 2 to 24 months. Pediatrics. 2011 Sep;128(3):595–610.
