CKS is no longer commissioned by the National Institute for Health and Clinical Excellence (NICE). NICE remains committed to providing a replacement service for CKS and is currently reviewing its options. In the meantime, although CKS content is now not being maintained, it still remains relevant and will continue to be made available. CKS content was generated under a programme of topic creation and update. To check if the topic you are viewing is current or out of date, please refer to the topic publication details by clicking on the 'How up-to-date is this topic?' link in the left hand menu on individual topic pages.
Urinary tract infection (lower) - women - Management
How should I follow up a pregnant woman with cystitis?
- Review culture results when available and, if necessary, change to an antibiotic that the organism is sensitive to.
- Send urine cultures to screen for asymptomatic bacteriuria 7 days after completion of treatment, and at every antenatal visit until delivery.
- If a group B streptococcus is isolated, inform the antenatal care service, as prophylactic antibiotics may be indicated during labour and delivery.
Basis for recommendation
Following up to ensure eradication of infection
- Following up to ensure eradication of infection is a pragmatic recommendation [SIGN, 2006].
- Subsequent screening for asymptomatic bacteriuria at antenatal visits is a pragmatic recommendation.
Managing incidentally-found group B streptococcus infection
- The antenatal care service should be informed when a group B streptococcus (GBS), Streptococcus agalactiae, is isolated from urine. GBS bacteriuria, even if treated, may be associated with increased risk of neonatal GBS disease, and so antibiotic prophylaxis should be offered to the woman during delivery. This recommendation is based on expert opinion in guidelines from the Royal College of Obstetricians and Gynaecologists [RCOG, 2003].
© NHS Institute for Innovation and Improvement