To treat or not to treat asymptomatic bacteriuria in renal transplant patients, A systematic review

Abstract

Background: Antibiotic therapy as a preventative measure for asymptomatic bacteriuria (AB) in kidney recipients can be beneficial in reducing subsequent symptomatic infections. Treating AB and acute graft pyelonephritis is crucial for reducing the risk of graft rejection after kidney transplantation, However, the effectiveness of antibiotics in these cases is still debate in the medical community. Objectives: This review aims to determine the benefits and risks of treating AB in kidney transplant recipients with antimicrobial agents to prevent symptomatic urinary tract infection (UTI) and all-cause mortality. Methods: The review included 10 articles published form January 2010 to January 2021 which examined the effectiveness of treating AB after renal transplantation. Results: AB treatment with antibiotics was found to have no benefit in all reviewed studies, as antibiotic treatment of AB increase the emergence of more resistant organisms in urine. During the months of follow-up, it was also a risk factor for UTI. Conclusion: Sufficient evidence has shown that AB treatment with antibiotics does not provide any significant benefit in the short and long term. Giving these findings, considering other important treatment options is vital to improve clinical outcome for this condition.