Antibiotherapy Choice in the Treatment of the Severe Forms of Urinary Tract Infections During Pregnancy

Abstract

Bacteriuria and urinary tract infection (UTI) are relatively common in pregnant women. It has been proven that bacteriuric patients have an increased incidence of acute pyelonephritis, premature labour and fetal loss. These compli cations can be avoided by proper eradication of UTI in early pregnancy, especially in gravidas suffering from diabetes mellitus and in those with previous UTI. The aim of this study was to investigate the antibiotherapy choice in the treatment of the severe forms of urinary infections in pregnancy. A retrospective study was made on 46 prospectively followed-up high risk pregnancy patients. The presence of bacteriuria was analyzed in relation to previous UTI (Group 1) and in relation to diabetes mellitus (Group 2). Urinary tract infections were found to be more frequent than microbial contamination (27:19), and microbes appeared more often in dia betic patients (p<0.01). The incidence of positive urine cultures were the highest in the third trimester gravidas, almost equally in both groups. Analyzing the microbial aspect of UTI causes it was found that E.coli predominates. This microbe was discovered in 70.37% of urine cultures, while Enterococcus, Klebsiella, P. mirabilis and Saprophytes were diagnosed less often. Pregnant women with confirmed in fection received antibiotics according to antibiograms. Ten-day cephtriaxon therapy (2 g daily) resulted in sterile urine cultures in all the probands with no side effects for mother and fetus, while other antibiotics were less efficient. Therefore, we recommend this antibiotic for the treatment of UTI in high risk pregnancies. (Thai J Obstet Gynaecol 1993; 5:33-37.)