Routine Urine Tests Not Advised For Diabetic Women
posted 12/02/02
NEW YORK (Reuters Health) - Women with diabetes do not need routine screenings to check for bacteria in their urine, as some doctors recommend, according to a new report.
Such screenings currently are followed by antibiotic treatment if bacteria are present--even if the patient is not experiencing any symptoms of a urinary tract infection. The rationale has been that eliminating the bacteria would decrease symptomatic urinary tract infections that can become much more severe than in nondiabetic women, possibly leading to serious kidney infections and hospitalizations.
But the new results, published in the November 14th issue of The New England Journal of Medicine, show that antibiotic treatment did not help prevent symptomatic infections or complications from them.
"There are no benefits to obtaining routine urine cultures from diabetic women," said study author Dr. Lindsay Nicolle, a professor of internal medicine at the University of Manitoba in Winnipeg, Canada.
In an editorial accompanying the study, Dr. Vincent Andriole, a professor of medicine at Yale University School of Medicine in New Haven, Connecticut, writes that the findings "should lead to a change in our delivery of healthcare to women with diabetes."
Resources now spent on screening and treatment should be used to identify the factors that lead to symptomatic infections in women with diabetes, he added.
Common symptoms of urinary tract infections include an urgent need to urinate and pain and burning during urination.
The study involved 55 diabetic women with bacteria in their urine but no symptoms who were given antibiotics and another 50 who were given an inactive placebo. They were screened every 3 months for up to 3 years. All women who developed a symptomatic infection were given antibiotics to treat it.
During an average follow-up of 27 months, similar percentages of women in each group developed at least one symptomatic urinary tract infection--42% in the treated group and 40% in the placebo group.
In addition, there were no significant differences between the groups in the rates of kidney infections or hospitalizations for urinary tract infections, the report indicates.
Health experts are worried about the overuse of antibiotics, which can lead to strains of bacteria that are resistant to the drugs.
"This is one opportunity where we can decrease the use of antibiotics, and that should potentially have an impact on resistance," Nicolle told Reuters Health.
The study was partly funded by Bayer, which makes ciprofloxacin, one of the antibiotics used in the trial.
Source: iVillage: Reuters Health.
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