Benefits , harms , and costs Guideline implementation should result in a reduction of cost and related harm of administering antibiotics when not required and a reduction of infection and related morbidities when antibiotics have demonstrated a proven benefit .
Abstract Objective To review the evidence and provide recommendations on antibiotic prophylaxis for gynaecologic procedures .
Outcomes Outcomes evaluated include need and effectiveness of antibiotics to prevent infections in gynaecologic procedures .
A prospective study of asymptomatic bacteriuria in sexually active young women.
BACKGROUND Asymptomatic bacteriuria is common in young women , but little is known about its pathogenesis , natural history , risk factors , and temporal association with symptomatic urinary tract infection . METHODS We prospect ively evaluated 796 sexually active , nonpregnant women from 18 through 40 years of age over a period of six months for the occurrence of asymptomatic bacteriuria ( defined as at least 10(5 ) colony-forming units of urinary tract pathogens per milliliter ) . The women were patients at either a university student health center or a health maintenance organization . Periodic urine cultures were taken , daily diaries were kept , and regularly scheduled interviews were performed . Escherichia coli strains were tested for hemolysin , the papG genotype , and the ribosomal RNA type . RESULTS The prevalence of asymptomatic bacteriuria ( the proportion of urine cultures with bacteriuria in asymptomatic women ) was 5 percent ( 95 percent confidence interval , 4 percent to 6 percent ) among women in the university group and 6 percent ( 95 percent confidence interval , 5 percent to 8 percent ) among women in the health-maintenance-organization group . Persistent asymptomatic bacteriuria with the same E. coli strain was rare . Symptomatic urinary tract infection developed within one week after 8 percent of occasions on which a culture showed asymptomatic bacteriuria , as compared with 1 percent of occasions when asymptomatic bacteriuria was not found ( P<0.001 ) . Asymptomatic bacteriuria was associated with the same risk factors as for symptomatic urinary tract infection , particularly the use of a diaphragm plus spermicide and sexual intercourse . CONCLUSIONS Asymptomatic bacteriuria in young women is common but rarely persists . It is a strong predictor of subsequent symptomatic urinary tract infection
Benefits , harms , and costs Guideline implementation should result in a reduction of cost and related harm of administering antibiotics when not required and a reduction of infection and related morbidities when antibiotics have demonstrated a proven benefit .
Abstract Objective To review the evidence and provide recommendations on antibiotic prophylaxis for gynaecologic procedures .
Outcomes Outcomes evaluated include need and effectiveness of antibiotics to prevent infections in gynaecologic procedures .