USPSTF Eases Recommendation for Asymptomatic Bacteriuria Screening in Pregnant Women

By Amy Orciari Herman

Edited by David G. Fairchild, MD, MPH, and Lorenzo Di Francesco, MD, FACP, FHM

The U.S. Preventive Services Task Force is still advising that clinicians screen pregnant women for asymptomatic bacteriuria, but it's downgraded the strength of the recommendation from grade A to grade B.

In 2008, the task force gave its strongest recommendation to screening in pregnant women, concluding with high certainty that the net benefit in terms of preventing perinatal complications was "substantial." Now, the group classifies the benefit as "no greater than moderate." Among the reasons for the change: In recent decades, pyelonephritis has only rarely occurred among pregnant women with untreated asymptomatic bacteriuria. Additionally, the harms of treating screen-detected asymptomatic bacteriuria — including antibiotic side effects and bacterial resistance — are "at least small."

As in 2008, the group continues to recommend against screening in nonpregnant adults (grade D recommendation).

Both recommendations are still in draft form. The public may comment on them until May 20 at the fourth link below.