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TUESDAY, April 2, 2019 (Pharmacist'sd Briefing) -- Recommendations have been updated for the management of asymptomatic bacteriuria (ASB); the Infectious Diseases Society of America clinical practice guideline was published online March 21 in Clinical Infectious Diseases.
Lindsay E. Nicolle, M.D., from the University of Manitoba in Winnipeg, Canada, and colleagues updated recommendations from the 2005 guideline for the management of ASB from the Infectious Diseases Society of America, including consideration of populations not addressed in the 2005 guideline.
The authors note that nontreatment of ASB represents an important opportunity for decreasing inappropriate antimicrobial use. Screening for or treating ASB is not recommended for infants and children; healthy premenopausal, nonpregnant women or healthy postmenopausal women; older, community-dwelling individuals who are functionally impaired; older residents in long-term care facilities; patients with diabetes; renal transplant recipients who have had renal transplant surgery more than one month prior; nonrenal solid organ transplant recipients; patients with spinal cord injury; patients with a short-term indwelling urethral catheter; and patients undergoing elective nonurologic surgery. Screening for and treating ASB is recommended for pregnant women and for patients undergoing endoscopic urologic procedures associated with mucosal trauma. Assessment for other causes and careful observation is recommended rather than antimicrobial treatment for older patients with functional and/or cognitive impairment. No recommendation was made for or against screening or treatment for patients with high-risk neutropenia.
"The guidelines are not intended to replace clinical judgment in the management of individual patients," the authors write.
Several authors disclosed financial ties to the pharmaceutical and medical technology industries.
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