Management of Asymptomatic Bacteriuria in Patients with Diabetes Mellitus

Abstract

OBJECTIVE

To review the literature regarding the management of asymptomatic bacteriuria (ASB) in patients with diabetes mellitus.

DATA SOURCES

A MEDLINE (1967–June 2003) and bibliographic search of the English-language literature was conducted using the search terms diabetes mellitus, asymptomatic, bacteriuria, and urinary tract infection.

DATA SYNTHESIS

ASB occurs in diabetic women more commonly than in non-diabetics and is associated with an increased risk of symptomatic urinary tract infection (UTI) among patients with type 2 diabetes. Symptomatic UTIs tend to follow a more complicated course in diabetics. Despite these independent observations, antimicrobial therapy has not been shown to reduce symptomatic UTIs, pyelonephritis, or hospitalization for UTI.

CONCLUSION

Available evidence does not support antimicrobial treatment of ASB among patients with diabetes mellitus.