Renal patients with asymptomatic bacteriuria do not need to be treated: results of a pilot observational audit

IntroductionTreatment of asymptomatic bacteriuria remains a common cause of inappropriate antibiotic use, particularly among patients with multiple comorbidities such as renal disease.MethodsA pilot, retrospective, observational audit of 200 renal patients was conducted to evaluate significant differences in readmission and mortality rates between patients with asymptomatic bacteriuria (who were not given antibiotic treatment) and patients with symptomatic urinary tract infections.ResultsNineteen (9.5%) patients had bacteriuria: 12 with symptomatic urinary tract infection and 7 with asymptomatic bacteriuria. None of the patients with asymptomatic bacteriuria were treated with effective antibiotics. There was no difference in readmission (42.9% v. 33.3%;P = 1.00) or mortality rates (0% v. 8.3%;P = 1.00) for patients with untreated asymptomatic bacteriuria when compared with patients with symptomatic urinary tract infections.ConclusionsThis pilot study suggests that it is safe not to treat asymptomatic bacteriuria in renal patients.