- Definition of asymptomatic bacteriuria: two consecutive voided urine cultures with ≥ 108 cfu/L of same organism +/- pyuria, and NO symptoms of UTI.

- Asymptomatic bacteriuria with uropathogens in pregnant women should be treated as it is associated with increased incidence of pyelonephritis, preterm labour, and low birthweight infants.

- Screening for bacteriuria recommended at 12-16 weeks gestation, or first prenatal visit if later than 12-16 weeks gestation.

- Post treatment urine cultures recommended 1 week after completion of treatment followed by monthly urine cultures for remainder of pregnancy.

Usual Pathogens

E. coli
Other Enterobacterales
S. agalactiae (Group B Strep)
S. saprophyticus

Options in pregnancy based on C&S results

Empiric Therapy Dose Duration
Amoxicillin 500mg PO tid 5 days
Cephalexin 250-500mg PO qid 5 days
Cefixime 400mg PO daily 5 days
Nitrofurantoin Macrobid 100mg PO bid or 50-100mg PO qid  5 days
TMP/SMX 1 DS tab PO bid 3 days
Trimethoprim 100mg PO bid 3 days