What is an Evidence Summary?
Key messages from scientific research that's ready to be acted on
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In older people with bacteria in their urine and no symptoms, antibiotics may not prevent development of urinary tract infection
Koves B, Cai T, Veeratterapillay R, et al. Benefits and Harms of Treatment of Asymptomatic Bacteriuria: A Systematic Review and Meta-analysis by the European Association of Urology Urological Infection Guidelines Panel. Eur Urol. 2017;72:865-8.
In people with bacteria in their urine and no symptoms (asymptomatic bacteriuria), does treatment improve outcomes?
People can have bacteria in their urine without any obvious symptoms of infection, such as pain with urination, frequent need to urinate, low back pain, confusion, or fever. Women, older adults, and people who have had urinary tract surgery are more likely to get asymptomatic bacteriuria. However, we don’t know if antibiotics may be helpful to treat some people who are at higher risk for getting a urinary tract infection.
How the review was done
The researchers did a systematic review of studies available up to November 2016. They looked at studies of different kinds of people with asymptomatic bacteriuria. For this summary, we will focus on the 3 randomized controlled trials that assessed treatments to prevent urinary tract infections in 210 older people living in nursing homes or other institutions.
The key features of the 3 studies of older people living in nursing homes or institutions were:
- people were older than 18 years of age and had asymptomatic bacteriuria;
- treatments included different kinds of antibiotics;
- treatments were compared with placebo or no treatment; and
- people were followed for 6 to 11 months.
All studies were considered to be very low quality, which means that new studies might show different results.
What the researchers found
Compared with placebo or no treatment, antibiotics did not reduce development of new symptomatic urinary tract infections in older people living in institutional settings.
In older people who live in nursing homes or other institutions and have bacteria in their urine, antibiotics may not prevent development of symptomatic urinary tract infections. Overall, evidence was of very low quality.
Antibiotics vs control* in older people living in nursing homes or other institutions who have bacteria in their urine
Symptomatic urinary tract infections
3 trials (210 people)
No difference in effect‡
A harmless, inactive, and simulated treatment.
Randomized controlled trials
Studies where people are assigned to one of the treatments purely by chance.
A comprehensive evaluation of the available research evidence on a particular topic.
Related Evidence Summaries
Cochrane Database of Systematic Reviews (2011)
Cochrane Database Syst Rev (2016)
Cochrane Database of Systematic Reviews (2013)
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DISCLAIMER These summaries are provided for informational purposes only. They are not a substitute for advice from your own health care professional. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the McMaster Optimal Aging Portal