Skip to main navigation
Skip notifications
Access to POEMs and Essential Evidence Plus will no longer be included in CMA membership as of Dec. 1, 2023.
Search
USPSTF 2019 recommends screening pregnant persons for asymptomatic bacteriuria (B recommendation)
Clinical Question
Should primary care clinicians screen pregnant persons for asymptomatic bacteriuria?
Bottom line
In this updated 2019 review, The U.S. Preventive Services Task Force (USPSTF) recommends that primary care clinicians screen pregnant persons for asymptomatic bacteriuria using a midstream, clean-catch urine culture at the first prenatal visit or at 12 to 16 weeks gestation, whichever is earlier. (B recommendation) The Task Force recommends against screening for asymptomatic bacteriuria in nonpregnant adults. (D recommendation) These recommendations are a change in grade for pregnant persons from an "A" to a "B" recommendation compared to the previous 2008 USPSTF recommendation statement. (Other patient-oriented evidence) 2c
Reference
Study design: Practice guideline
Funding: Government
Setting: Population-based
Synopsis
In this updated review, the Task Force found adequate evidence that treatment of screen-detected asymptomatic bacteriuria can reduce the incidence of pyelonephritis in pregnant persons and associated complications including low infant birth weight. The Task Force also found that evidence of harm associated with treatment including adverse effects of antibiotic treatment is at least small in magnitude. However, given newer evidence that the risk of pyelonephritis is significantly lower that found in previous reviews, the Task Force changed the grade for pregnant persons from an "A" to a "B" recommendation (moderate certainty of moderate net benefit). There is no evidence that treatment of screen-detected asymptomatic bacteriuria in otherwise low risk nonpregnant adults has any benefit. The current recommendations are consistent with guidelines released by the American College of Obstetricians and Gynecologists, the Canadian Task Force, and the American Academy of Family Physicians.
Reviewer
David C. Slawson, MD
Professor and Vice Chair of Family Medicine for Education and Scholarship
Atrium Health
Professor of Family Medicine, UNC Chapel Hill
Charlotte, NC