The natural history of asymptomatic bacteriuria during pregnancy: The effect of tetracycline on the clinical course and the outcome of pregnancy

Abstract

In this study of bacteriuria in pregnancy, the course of 133 tetracycline-treated and 148 placebo-treated bacteriuric patients was compared with the course of 279 matched nonbacteriuric pregnant control subjects, of whom 147 received tetracycline and 132 received placebos. Tetracycline-treated bacteriuric patients whose bacteriuria either did not clear with tetracycline or whose bacteriuria recurred prior to delivery and placebo-treated bacteriuric patients who developed symptomatic pyelonephritis had higher rates of prematurity than did other bacteriuric patients. If the bacteriuria was resistant to the first course of therapy, it was likely to be resistant to subsequent courses of therapy. Bacteriuric patients whose bacteriuria cleared were 8 times more likely to have a recurrence prior to delivery than were the nonbacteriuric patients who served as controls. Sixteen per cent of the bacteriuric patients who did not receive successful antimicrobial therapy developed symptomatic pyelonephritis. Nonbacteriuric patients who took 6 weeks of tetracycline had a significant reduction in the rate of premature delivery.