Management of Asymptomatic Bacteriuria in Adult Female Populations

This Clinical Consensus Statement on the management of asymptomatic bacteriuria (ASB) in adult females reflects statements drafted by content experts within the American Urogynecologic Society Bacteriuria Writing Group. The writing group created 32 clinically relevant topic questions, which were collapsed into 30 questions due to thematic overlap. The group used a modified Delphi process to evaluate the statements for consensus. Eight out of 30 questions did not reach consensus after the first Delphi round. Based on group discussion, several questions were restructured or omitted and 25 were retained. Consensus was reached on all 25 statements after 2 further rounds of discussion. Evidence summaries were developed from a structured literature search and are presented with each topic question and statement. Overall, ASB is common and increases with age in the female population. Treatment of ASB is thought to confer more harm than benefit in most women. For women with chronic lower urinary tract symptoms and bacteriuria, an acute change in symptoms should be evaluated with urinalysis and urine culture to guide decision making for antimicrobial therapy.