TABLE 3.
Choosing wisely recommendations for asymptomatic bacteriuria
| Society | Recommendation |
|---|---|
| Choosing Wisely United States (http://www.choosingwisely.org/clinician-lists) | |
| American Academy of Pediatrics | Avoid the use of surveillance cultures for screening and treatment of ASB |
| American Geriatrics Society (Feb 27, 2014) | Do not use antimicrobials to treat bacteriuria in older adults unless specific urinary tract symptoms are present |
| The Society for Post-Acute and Long-Term Care Medicine (AMDA) (Mar 20, 2015) | Do not obtain a urine culture unless there are clear signs and symptoms that localize to the urinary tract |
| Infectious Diseases Society of American (IDSA) | Do not treat ASB with antibiotics |
| Society for Healthcare Epidemiology of America (SHEA) | Do not perform urinalysis, urine culture, blood culture, or C. difficile testing unless patients have signs or symptoms of infection; tests can be falsely positive, leading to overdiagnosis and overtreatment |
| American Urological Association (June 11, 2015) | Prescribing antimicrobials to patients using indwelling or intermittent catheterization of the bladder unless there are signs and symptoms of urinary tract infection |
| Choosing Wisely Canada (https://choosingwiselycanada.org) | |
| Association of Medical Microbiology and Infectious Disease Canada (Feb 1, 2017) | Do not obtain a urine culture from adults who lack symptoms localizing to the urinary tract or fever, unless they are pregnant or undergoing genitourinary instrumentation where mucosal bleeding is expected |
| Canadian Association of Pathologists (Oct 29, 2014) | Do not obtain urine culture on asymptomatic patients, including elderly patients, patients with diabetes, or as a follow-up to confirm effective treatment |
| Canadian Geriatrics Society (Apr 2, 2014) | Do not use antimicrobials to treat bacteriuria in older adults unless specific urinary tract symptoms are present |
| Canadian Nurses Association (Jan 9, 2017) | Do not treat bacteriuria in older adults unless specific urinary tract symptoms are present |
| Canadian Nurses Association/Infection Prevention and Control Canada (Nov 2017) | Do not do urine dipstick or culture unless urinary tract symptoms are present |
| Long Term Care Medical Directors Association of Canada (Jan 18, 2017) | |
| Canadian Society of Hospital Medicine (June 2, 2015) | Do not prescribe antibiotics for ASB in nonpregnant patients |
| Canadian Urological Association (Oct 29, 2014) | Do not treat asymptomatic bacteriuria in elderly patients |
| Choosing Wisely Australia (www.choosingwisely.org.au) | |
| Australasian Society for Infectious Diseases (Mar 1, 2016) | Do not use antibiotics in asymptomatic bacteriuria |
| Australian and New Zealand Society for Geriatric Medicine (Aug 9, 2016) | Do not treat bacteriuria in older adults where specific urinary tract symptoms are not present |
| Royal College of Pathologists of Australasia (Apr 22, 2015) | Do not perform surveillance urine cultures or treat bacteriuria in elderly patients in the absence of symptoms or signs of infection |