Asymptomatic bacteriuria (ASB) should only be treated in specific, limited patient poAsymptomatic bacteriuriapulations: pregnant women and patients undergoing invasive urological procedures .
The evidence consistently shows that treating ASB in most patient groups is not only ineffective but potentially harmful. Multiple systematic reviews found no benefit in treating ASB for patients with diabetes, elderly individuals, those with indwelling catheters, or patients with spinal cord injuries. In fact, unnecessary antibiotic treatment risks adverse effects and contributes to antimicrobial resistance.
The strongest evidence supports treatment only for pregnant women, where ASB treatment can decrease risks of symptomatic urinary tract infections, low birthweight, and preterm delivery .