2. Upto 1 out of 10
pregnant women
suffer from
ASB
1. Small FM et al. antibiotics for asymptomatic
bacteriuria in pregnancy.
Cochrane database systrev. 2015 Aug
7;8:CD000490
3. Early detection & prompt treatment is
necessary to avoid consequences 1’2
• Progression acute pyelonephritis
(Upto 30% cases)
• Increased risk of premature delivery
& low birth weight
1. Small FM et al.antibiotics for asymptomatic bacteriuria in pregnancy. Cochrane database systRev. 2015 Aug 7;8:CD000490
2. Prakash j. the kidney in pregnancy: A journey: A journey of three decedes. India J nephto;. 2012May;may;22(3);159-67
4. SCREENING
• Pregnant women should be offered
routine screening for ASB* by
midstream routine urine
examination 3
• Urine culture should be asked
where indicated 3
*ASB- Asymptomatic Bacteriuria.;
3. ICOG FOGSI recommendations for good clinical practice. Routine antenatal care for the healthy pregnant women.
Available http://www.fogsi.org/index.php?option=com_content&view=article&id=93&itemid=16accessedon:april 05,2016
5. DIAGNOSIS
• Mid – stream sample of urine (MSU)
showing bacterial growth ≥ 105cfu/ml
in two consecutive sample in women
without symptoms from the urinary
tract4
cfu;:colony-forming unit
4. Grade M et al. guidelines on urological infection. EAU 201 (update on march 2015; cited on : April 05, 2016). Available at:
http://uroweb.org/guideline/urological-infections/
6. MANAGEMENT
• IDSA2005GUIDELINE ON ASYMPTOMATIC
BACTERIURIA IN ADULTS, RECOMMENDS- 5
* pregnant women with positive urine culture
report should be treated (A-I)˄,5
The duration of antimicrobial therapy should
be 3-7 days (A-II) ˄,5
˄ IDSA clinical grading system:5
Strength of recommendation :A good evidence to support a recommendation for use; should always be offered ofevidence:
1- evidence from ≥ 1 properly randomized, controlled trial; ii evidence ≥ 1 well designed clinical trial , wothout
rendomization ; from cohort or case controlled analysis syudies ( preferably from 11 center); from multiple time – series; or
from dramatic results from uncontrolled experiments.
7. SANFORD GUIDELINES 2015
ORAL CEPHALOSPORIN AS ONE OF THE
AGENTS IN ASB* DURING PREGNANCY
*ASB-asymptomatoc bacteriuria
6. Gilbert DN et al. the sanford guide to antimicrobial therapy 2015, 45th edition. Sperryville,
USA: antimicrobial therapy, inc; January 2015: pg.35
7. Ceftum tables prescribing information. Glaxosmithkline, india version: CEF/PI/IN/2015/01
dated 28 january 2015
8. Special care in patients allergic to
pencillin or beta lactams
Use of CEFTUM in pregnancy & lactations:
There is no experimental evidence of
embryopathic or teratogenic effects attributable
to CEFTUM but, as with all drugs, it should be
administered with caution during the early
months of pregnancy.
Cefuroxime is excreted in human milk, &
consequently caution should be exercised when
CEFTUM is administered to a nursing mother
9. ADDRESS
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Karkari Morh Flyover,
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