The Particulars: Studies have suggested that asymptomatic bacteriuria (AB) should not be treated in most patients, but the definition of the term “asymptomatic” is often unclear when applied to acutely ill patients in the ED. These individuals may have any number of presenting symptoms that are attributable to urinary tract infections (UTIs), which can result in treatment with antibiotics.

Data Breakdown: For a study, investigators examined the range of presenting signs and symptoms that triggered the initiation of antibiotics in patients being admitted from the ED with a UTI diagnosis. Among those with urinalyses testing positive for pyuria, nitrites, or leukocyte esterase, 82% received antibiotics in the ED for their UTI or other infection without or without UTI. Of those treated for UTIs, 42% had no urinary symptoms or systemic signs of infection, and none had an indication to treat asymptomatic bacteriuria.

Take Home Pearl: Nearly half of patients diagnosed with UTIs and treated with antibiotics in the ED appear to have asymptomatic bacteriuria without a clear indication or need for antibiotic treatment.