• Comparison of the effectiveness of antibacterial therapy regimens in the treatment of asymptomatic bacteriuria during pregnancy

Comparison of the effectiveness of antibacterial therapy regimens in the treatment of asymptomatic bacteriuria during pregnancy

HEALTH OF WOMAN. 2018.5(131):57–60; doi 10.15574/HW.2018.131.57

Romanenko T. G., Sulimenko O. M.
Shupyk National Medical Academy of Postgraduate Education MH of Ukraine, Kiev

The objective: to evaluate the effectiveness of the proposed therapy in pregnant women with asymptomatic bacteriuria.

Materials and methods. All patients were divided into two groups. І group – 38 patients received the course of amoxicillin with clavulanic acid 625 mg per os twice a day for 7 days, group II – 33 patients received D-mannose (1.2 g), powder of 5.8 g in a sachet 2 times a day for 7 days. Diagnostic criteria for asymptomatic bacteriuria were based on practical recommendations of the American Society of Infectious Diseases.

Results. In the first cultural research of the urine specimen (immediately after the end of the course of therapy), the percentage of microorganism’s persistence in the urinary tract of a woman was determined, in case of its detection, an additional course of treatment was prescribed. In the second and subsequent control urine samples, the percentage of relapsing bacteriuria was determined. Percentage of the persistence of the pathogen in the urinary tract among the treated women with bacteriuria remained rather low – 10.5% (4 patients) in group I, but higher than in group II 3.1% (1 patient). The percentage of sterile first urine sample was high and probably did not differ between groups – 31 (81.6%) and 32 (96.9%) women respectively in I and II groups. In the first group, the percentage of relapses during gestation after the diagnosed and treated bacteriuria remained rather high and amounted to 23.7% (9 patients), and in the second group, the relapse was not recorded.

Conclusions. The 7-day course of therapy with the D-mannose drug is associated with fewer cases of persistent pathogenic pathogens in urine, no recurrence of bacterial infection, and no side effects.

Key words: asymptomatic bacteriuria, D-mannose, urinary tract, pregnancy.


1. Markin LB, Popovych AI, Shatylovych KL. 2013. Ratsionalne farmakolikuvannia bezsymptomnoi bakteriurii u vahitnykh. Lvivskyi klinichnyi visnyk 4(4):27–30.

2. Rynzhuk VIe, Rynzhuk LV, Danchuk AH. 2010. Mikrobnyi peizazh sechi vahitnykh z bezsymptomnoiu bakteriuriieiu: perevazhni zbudnyky, yikh vydovyi sklad ta populiatsiinyi riven. Klinichna ta eksperymentalna patologiуa 9;4:89–90.

3. Ordzhonikidze KV, Petrova SB, Emelyanova AI. 2009. Profilaktika i lechenie oslozhneniy u beremennyih i rodilnits s zabolevaniyami mochevyivodyaschih putey. Akusherstvo i ginekologiya 6:41–45.

4. Lumbiganon P, Laopaiboon M, Thinkhamrop J. 2010. Screening and treating asymptomatic bacteriuria in pregnancy. Curr Opin Obstet Gynecol. 22:95-9.

5. Farkash E, Wientraub AY, Sergienko R et al. 2012. Acute antepartum pyelonephritis in pregnancy: a critical analysis of risk factors and outcomes. Eur J Obstet Gynecol Reprod Biol. 162:24-7. 10 https://doi.org/10.1016/j.ejogrb.2012.01.024; PMid:22381037

6. Bahadi A, El Kabbaj D, Elfazazi H et al. 2010. Urinary tract infection in pregnancy. Saudi J Kidney Dis Transpl. 21:342-4. PMid:20228527

7. Schnarr J, Smaill F. 2008. Asymptomatic bacteriuria and symptomatic urinary tract infection in pregnancy. Eur J Clin Invest. 38(2):50-7. 9.

8. Gravett MG, Martin ET, Bernson JD et al. 2012. Serious and life threatening pregnancy related infections: opportunities to reduce the global burden. Plos Med. 9:e1001324. https://doi.org/10.1371/journal.pmed.1001324; PMid:23055837 PMCid:PMC3467240

9. Bolton M, Horvath DJ, Li B et al. 2012. Intrauterine growth restriction is a direct consequence of localized maternal uropathogenic Escherichia coli cystitis. Plos ONE. 7:1-9.