Asymptomatic bacteriuria treatment is associated with a higher prevalence of antibiotic resistant strains in women with urinary tract infections.

Background. Women suffering from recurrent urinary tract infections (rUTIs) are routinely treated for asymptomatic bacteriuria (AB), but the consequences of this procedure on antibiotic resistance are not fully known. The aim of this study was to evaluate the impact of AB treatment on antibiotic resistance among women with rUTIs. Methods. The study population consisted of 2 groups of women who had previously been enrolled in a randomizedclinicaltrial:group Awasnottreated,and group B wastreated. All women were scheduledfor follow-upvisitsevery 6 months, or more frequently if symptoms arose. Microbiological evaluation was performed only in symptomatic women. All women were followed up for a mean of 38.8 months to analyze data from urine cultures and antibiograms. Results. The previous study population consisted of 673 women, but 123 did not attend the entire follow-up period. For the final analysis, 257 of the remaining 550 patients were assigned to group A, and 293 to group B. At the end of follow-up, the difference in recurrence rates was statistically significant (P<.001): 97 (37.7%) in group Aversus 204 (69.6%) in group B. Isolated Escherichia coli from group B showed higher resistance to amoxicillin–clavulanic acid (P= .03), trimethoprim-sulfamethoxazole (P= .01), and ciprofloxacin (P= .03) than that from group A. Conclusions. This studyshowsthat AB treatment is associated with a higheroccurrence of antibiotic-resistant bacteria, indicating that AB treatment in women with rUTIs is potentially dangerous.