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KCE reports vol. 6A Prenatale zorg 76 Study Ref Population Intervention Outcomes Results Comments Study type EL Ireland bacteriuria bacteriuria Little, 1966 4 [329] Women attending two Antibiotic treatment vs. Incidence of 265/5000 No method of RCT 1b antenatal clinics in two treatment of ÂcasesÊ only when asymptomatic (5.3%) randomisation London hospitals symptomatic bacteriuria described Etherington and 4 [342] 898 women attending Test evaluation study Incidence of 27/898 TES 3 James, 1993 antenatal clinic in a Bristol asymptomatic (3%) (UK) hospital bacteriuria What are the maternal and perinatal outcomes associated with asymptomatic bacteriuria ? Study Ref Population Intervention Outcomes Results Comments Study Little, 1966 4 [329] Leblanc and McGanity, 1964 4 [332] Women attending two antenatal clinics in two London hospitals 4735 women without bacteriuria 265 women with bacteriuria diagnosed by culture of midstream urine on at least two occasions Screened at first antenatal visit 1325 women attending antenatal clinics in a US hospital enrolled at first clinic visit Antibiotic treatment vs. treatment of cases only when symptomatic Antibiotic used was sulphmethoxypyriazine for 30 days Randomisation of women found to be bacteriuria to no drug and three different drug regimens Maternal: pyelonephritis, toxaemia Fetal: perinatal mortality, preterm birth, fetal abnormalities Pyelonephritis in pregnancy Prematurity Pyelonephritis: more common in women with bacteriuria when untreated (24.8% vs. 7.6%) Toxaemia: no difference between groups Perinatal mortality: no difference between groups Preterm birth: higher in the women with bacteriuria (8.7% vs. 7.6%) Fetal abnormalities: no difference between groups Group [incidence of pyelonephritis]: - Initially negative culture (no Rx) [21/1028 (1.9%)] Method of randomisation was not indicated Method of randomisation was not indicated EL type RCT 1b RCT 1b
KCE reports vol. 6A Prenatale zorg 77 Study Ref Population Intervention Outcomes Results Comments Study type EL Urine samples collected by catheter and initial bacteriuria defined as colony counts of greater than 105 - Initially negative culture Follow-up rate of > 90% Antibiotics used were: and long-term Rx [1/115 1. Sulfamethizole and (0.9%)] mandelamine combination - Initially positive cultures 2 Nitofuradantoin and drug Rx [3/69 of a single Mandelamine alone (4.3%)] organism/ml 3. Mandelamine alone - Initially positive culture and no long-term Rx [8/41 (19.5%)] Group [incidence of prematurity]: - Initially negative culture (no Rx) [117/1003 (11.6%)] - Initially negative culture and long-term Rx [16/138 (11.6%)] - Initially positive cultures and drug Rx [7/101 (6.9%)] - Initially positive culture and no long-term Rx [6/27 (22.1%)] Foley et 4 220 women with Treatment vs. non- Percentage of Percentage with sterile urine: Randomisation was by RCT 1b al. ,1987 [331] asymptomatic treatment of women with participants with Treatment group: 73% coin tossing bacteriuria confirmed bacteriuria; 100 sterile urine Non-treatment: 48% treated, 120 not treated Allocation concealment Hospital in Ireland Incidence of Incidence of symptomaticUTi: method not indicated symptomatic urinary ASB group: 2.3% tract infections Sterile urine group: 0.5% Follow-up rate 81% Bacteriuria defined as 10 5 organisms per ml in a single midstream specimen of urine Antibiotics used were either sulphametizole or nitrofurantoin Incidence of pyelonephritis Incidence of pyelonephritis: Treatment group: 3/100 Method of analysis not indicated
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NATIONALE RICHTLIJN PRENATALE ZORG:
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KCE reports 1. Effectiviteit en kos
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