PEOPLE WHO have bacteria in their urine, but have no symptoms of a urinary tract infection should not be treated with antibiotics, according to new research from NUI Galway. The only ones who should be treated for bacteria in the urine when there are no other symptoms are pregnant women, according to Martin Cormican, professor of bacteriology at NUIG and a consultant microbiologist.
He says it is a fairly common belief, even among healthcare professionals, that people with bacteria in the urine at levels often regarded as clinically significant – known as asymptomatic bacteriuria (ASB) – have a hidden infection and that they should be treated with antibiotics to prevent them from getting sick in the future.
In a new paper published in the latest edition of the British Medical Journal, Prof Cormican, along with Dr Akke Vellinga and Prof Andrew Murphy of NUI Galway's School of Medicine, looked at all the evidence that has been built up in this field over the years.
“It is very clear that with the important exception of women who are pregnant, ASB is quite harmless and should be left alone in almost all cases,” he writes. “This is an important message because over-use of antibiotics is an important factor in increasing the problems we have throughout the world with antibiotic-resistant bacteria.”
The researchers also recommend that to avoid worrying the patient and to avoid wasteful expense, urine samples should be sent for testing for bacteria only when there is a good reason to suspect that the person has an infection, for example, when the patient has symptoms such as burning when passing urine.
Cystitis, which is an infection in the bladder, is common especially in women. About one in three women have cystitis at least once in their life and some have it several times a year. It is usually treated with antibiotics.
Many people who do not have symptoms of cystitis also have bacteria (usually E coli) present in the urine in the same numbers as people who have symptoms.
This is ASB and although it can be found in people of all ages, it becomes more common as people get older. About one in three women over the age of 70 and one in six men over the age of 70 have ASB.
