Cochrane: Urinary
tract infections (UTIs) are a common infection among women, with most
women having developed a UTI at least once in their lifetime.
Pyelonephritis, a UTI which affects the upper urinary tract and kidneys,
is one of the most prevalent conditions that require hospitalisation
among pregnant women.
In general, both urine and blood samples are taken for diagnosis and to tailor the necessary antibiotic therapy to the needs of the patient. Some severe cases of pyelonephritis require hospitalisation and intravenous administration of antibiotics. Several previous studies have reported that excluding blood testing or 'blood culture' samples and using only urine samples in managing the condition could be as safe and effective as the current approach, in which both urine and blood samples are analysed. Previous research has also suggested that urine samples render blood samples superfluous, as blood samples offer no additional clinical value for the management of pyelonephritis. Testing only urine samples could also be significantly cost-saving.
This review aims to evaluate the effectiveness of routine blood cultures in the management of pyelonephritis in pregnancy. However, we did not identify any data from randomised controlled trials in order to examine the efficacy of routine blood cultures in the management of the condition among pregnant women. Further research is required to assess the effectiveness of managing pyelonephritis in pregnant women with or without blood culture samples, as well as to address possible adverse outcomes and the potential cost-effectiveness of excluding blood cultures from treatment.
In general, both urine and blood samples are taken for diagnosis and to tailor the necessary antibiotic therapy to the needs of the patient. Some severe cases of pyelonephritis require hospitalisation and intravenous administration of antibiotics. Several previous studies have reported that excluding blood testing or 'blood culture' samples and using only urine samples in managing the condition could be as safe and effective as the current approach, in which both urine and blood samples are analysed. Previous research has also suggested that urine samples render blood samples superfluous, as blood samples offer no additional clinical value for the management of pyelonephritis. Testing only urine samples could also be significantly cost-saving.
This review aims to evaluate the effectiveness of routine blood cultures in the management of pyelonephritis in pregnancy. However, we did not identify any data from randomised controlled trials in order to examine the efficacy of routine blood cultures in the management of the condition among pregnant women. Further research is required to assess the effectiveness of managing pyelonephritis in pregnant women with or without blood culture samples, as well as to address possible adverse outcomes and the potential cost-effectiveness of excluding blood cultures from treatment.
Authors' conclusions:
There are no large-scale
randomised controlled trials to assess outcomes in the management of
pyelonephritis in pregnancy with or without blood cultures. Randomised controlled trials are needed to evaluate the effectiveness of managing pyelonephritis in pregnant women with or without blood cultures, and to assess any adverse outcomes as well as the cost-effectiveness of excluding blood cultures from treatment.