Should Recipients of Kidney Transplants Receive Treatment for Asymptomatic Bacteriuria?

Urinary tract infection (UTI) is common after kidney transplantation; the transplanted ureter can allow reflux of urine into the transplanted kidney, and many patients present with associated pyelonephritis in the absence of cystitis symptoms. Particularly during the early post-transplant period, clinicians often obtain urine cultures, typically as reflex testing after abnormal urinalysis. Is treatment necessary for asymptomatic bacteriuria? Researchers conducted a systemic review and meta-analysis of four trials involving some 480 recipients of kidney transplants who had asymptomatic bacteriuria and had been randomized to antibiotic treatment or no treatment.