When is treatment for asymptomatic bacteriuria indicated?

The treatment for asymptomatic bacteriuria is indicated specifically in pregnant women because they are at increased risk for developing pyelonephritis if bacteriuria is left untreated. During pregnancy, the physiological changes and potential complications can lead to adverse outcomes for both the mother and the fetus, making it crucial to treat any detected bacteria in the urine, even if there are no symptoms present.

In general, asymptomatic bacteriuria does not require treatment in most other populations, including adults, elderly patients, and diabetic individuals, unless they are undergoing procedures that may manipulate the urinary tract or if they develop symptoms indicating an infection. The current guidelines support treatment in pregnant women as a preventive measure to avoid complications, highlighting the importance of screening during prenatal care. This focused approach ensures that treatment is provided to those who benefit from it while avoiding unnecessary antibiotic use in other populations.