Bibliographic Info
GuidelineWHO recommendations on maternal health: guidelines approved by the WHO Guidelines Review Committee, second edition. Geneva: World Health Organization; 2025
Year of Publication2023
Issuing InstitutionWorld Health Organization
Recommendation
Status
Updated
Recommended
A seven-day antibiotic regimen is recommended for all pregnant women with asymptomatic bacteriuria (ASB) to prevent persistent bacteriuria, preterm birth and low birth weight.
Notes and Remarks
- 1.This recommendation should be considered alongside the recommendation on ASB diagnosis
- 2.Stakeholders may wish to consider context-specific ASB screening and treatment based on ASB and preterm birth prevalence, as it may not be appropriate in settings with low prevalence.
- 3.Evidence on preterm birth is of low certainty and large multicentre trials are needed to confirm whether screening and antibiotic treatment reduces preterm birth and perinatal mortality in LMICs. Such trials should also aim to evaluate the effects of group B streptococcus (GBS) screening and treatment.
- 4.Studies have shown that GBS bacteriuria is a sign of heavy GBS colonization, which may not be eradicated by antibiotic treatment. GBS bacteriuria is a risk factor for having an infant with early onset GBS disease. WHO recommends that pregnant women with GBS colonization receive intrapartum antibiotic administration to prevent early neonatal GBS infection (see WHO recommendations for prevention and treatment of maternal peripartum infections)
- 5.Preterm birth indicators should be monitored with this intervention, as should changes in antimicrobial resistance.