Tiêu đề UTI in pregnancy (asymptomatic bacteriuria).pdf ✅

Version: 11 June 2024 National Antimicrobial Guideline, 4th Edition (2024) Clinical Pathways for Primary Care: Urinary Tract Infection in Pregnancy (Asymptomatic Bacteriuria) Antibiotics Dosing Duration Remarks Nitrofurantoin* 50-100mg PO q6h (immediate release) OR 100mg PO q12h (modified release) 5 days Preferred Cephalexin 500mg PO q6h 5 days Preferred Amoxycillin / Clavulanate** 625mg PO q8h 5 days Alternative Ampicillin / Sulbactam 375-750mg PO q12h 5 days Alternative Cefuroxime 500mg PO q12h 5 days Alternative *Nitrofurantoin is contraindicated if eGFR is <30 ml/min and in third trimester. **Amoxycillin / Clavulanate is generally safe in pregnancy (category B) except for an increasing incidence of necrotizing enterocolitis in preterm babies and in babies born after premature rupture of membrane. *** Any group B Streptococcus in urine C&S, should be treated accordingly and also be given intrapartum antibiotic and in concurrent pregnancy. 1. Consensus Guidelines on The Management of Urinary Tract Infections in Pregnancy 2021 2. UTI (lower): Antimicrobial Prescribing. NICE Guideline May 2022. 3. The WHO AWaRe (Access, Watch, Reserve) antibiotic book 2022. Routine urine albumin / sugar screening If urine albumin +ve, perform urinalysis Nit +ve Unlikely UTI Nit –ve AND Leu –ve Suspected of asymptomatic bacteriuria (ADULT, PREGNANT): Asymptomatic Send urine C&S (May consider treatment with antibiotics if near term or delay in result expected) Send urine C&S Start antibiotic treatment Repeat urine C&S after completion of treatment Nit –ve AND Leu +ve CFU ≥105 CFU 103 -104 Review C&S result CFU <103 End Review symptoms and repeat urine C&S after 1 week