UTI & Asymptomatic Bacteriuria (In Pregnancy)
- Caused by the same pathogens as those that affect nonpregnant
patients, UTIs complicate roughly 5% of pregnancies. Risk factors
include bladder/kidney anomalies, gestational diabetes, and
multiparity. Rapid progression to pyelonephritis is the main risk of
UTIs in pregnancy.
- Obtain a clean-catch urine culture; perform routine screening at
the first prenatal visit.
- Treat with a short course of antibiotics; adjust treatment in
accordance with culture and sensitivity.
- Keflex 500mg po bid x 10 days
- Nitrofurantoin 100mg bid x 10 days
- Augmentin 500mg po bid x 10 days
Omnicef 300mg q12h x 10 days
- Ceftin 500mg po bid x 10 days
- Vantin 200mg po bid x 7-14 days (give w/food)
- Fosfomycin 3g single dose.
- Rocephin 1g IV qd x 10 days
- Obtain follow-up urine cultures.
- Hospitalize for IV antibiotics if pyelonephritis is suspected.
- GBS bacteriuria requires intrapartum antibiotic prophylaxis.
- Bacteriuria is also associated with an ↑ risk of
preterm birth and perinatal mortality.