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Table 2 Study characteristics

From: Benefits and harms of screening for and treatment of asymptomatic bacteriuria in pregnancy: a systematic review

Comparison study

Study design

Participants randomised (intervention / control)

Treatment regimen

Location / Setting / recruitment period

Length of follow-up

Urine collection / methods used for diagnosis

Inclusion and exclusion criteria

Sulphasymazine vs. placebo

Elder [19]

RCT, double-blind, parallel

106 (54 / 52)

Sulphasymazine 0.5 g/d until birth or onset of pyelonephritis; if bacteriuria persisted medication was changed to nitrofurantoin or tetracycline, dosage not stated

 USA / outpatient maternal care / 06 / 1965 – 03 / 1966

Until immediately after birtha

Clean voided / UC

I: pregnant; same species of bacteria in first 3 uncontaminatedb specimens, ≥ 104 /ml in one and ≥ 105/ml in 2

E: > 32th week of gestation at first examination

Sulphadimethoxine vs. no treatment

Mulla [20]

RCT, blinding not stated

100 (50 / 50)

Sulphadimethoxine 2 x 250 mg/d 7 days; if bacteriuria persisted treatment was repeated

USA / not stated / not stated

Until immediately after birtha

Catheter (not specified) / UC and “stained smear”c not further specified

I: 30th – 32th week of gestation; bacteriuria (not specified)

E: not stated

Sulphadimidine vs. no treatment

Williams [22]

RCT, blinding not stated

Not stated (85 / 78)d

Sulphadimidine 3 x 1 g 7 days; if bacteriuria persisted until 2 to 3 weeks after finishing primary treatment, then nitrofurantoin 2 x 100 mg/d for 7 days if still persisting ampicillin 3 x 250 mg for 7 days

GB / maternal care / 1967

10 days post partem

Voided midstream / UC

I: < 30th week of gestation at recruitment; > 105 g-negative bacteria /ml in ≥ 2 consecutive specimens

E: not stated

Nitrofurantoin vs. placebo

Kazemier [21]

Double-blind, placebo-controlled RCT, embedded in a multicentre cohort study

85 (40 / 45)

Nitrofurantoin 100 mg 2x/d 5 days, self-administered if follow-up culture positive one week after end of treatment, 1x repeated (masked) medication at the same dose and schedule

NL / hospitals and ultrasound centres / 10 / 2011 – 6 / 2013e

Until 08 / 2014

Not stated / dip slide with two culture media

I: women ≥ 18 years with a singleton pregnancy between 16 and 22 weeks; without symptoms of UTI; ≥ 1x105 CFU /ml of a single microorganism or when 2 different colony types were present but 1 with ≥ 1x105 CFU / ml

E: history of preterm delivery < 34 weeks; warning signs of an imminent preterm delivery; fetal congenital malformations; antibiotic use within 2 weeks of screening; known glucose-6-phosphate dehydrogenase deficiency; hypersensitivity to nitrofurantoin; risk factors for complicated UTI

  1. CFU colony forming units, GB Great Britain, I inclusion criteria, E exclusion criteria, g gram, ml millilitre, NL Netherlands, RCT randomised controlled trial, UC urinary culture, USA United States of America, UTI urinary tract infection
  2. aExact length of follow-up not stated, but outcomes were assessed that occurred immediately after birth
  3. bContamination was defined as a specimen with “large numbers of organisms that were likely to be of vaginal origin”
  4. cThe diagnostic strategy to identify the study population consisted of two different diagnostic tests. No details were reported on the specific catheter, the number of positive test results required, the cut-offs used, or the diagnostic algorithm (i.e., whether both tests were used as a combination and, if so, how the test results were combined to diagnose ASB)
  5. dOf originally 211 pregnant women with gram-negative asymptomatic bacteriuria, a subgroup of participants restricted to those with coliform bacteria was analysed in the relevant trial
  6. eRefers to the entire cohort study
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BMC Pregnancy and Childbirth

ISSN: 1471-2393

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