From the Guidelines
Streptococcus in urine does not necessarily require antibiotic treatment, especially in asymptomatic patients, as the risks of antimicrobial resistance and other harms may outweigh the benefits of treatment. The management of Streptococcus in urine should be guided by the principles of antimicrobial stewardship, which prioritize the responsible use of antibiotics to minimize the development of resistance and other adverse consequences 1.
Key Considerations
- The presence of Streptococcus in urine may indicate asymptomatic bacteriuria (ASB), which is a common finding in certain populations, such as older adults, individuals with indwelling catheters, and those with underlying medical conditions 1.
- The treatment of ASB is not recommended in most cases, as it has not been shown to provide significant benefits and may contribute to the development of antimicrobial resistance 1.
- The decision to treat Streptococcus in urine should be based on the presence of symptoms consistent with a urinary tract infection (UTI), such as dysuria, frequency, or urgency, rather than the presence of bacteria in the urine alone 1.
Management Strategies
- In asymptomatic patients, the presence of Streptococcus in urine should not prompt antibiotic treatment, unless there are specific risk factors or underlying conditions that increase the risk of developing a UTI 1.
- In patients with symptoms consistent with a UTI, antibiotic treatment should be guided by the results of urine culture and susceptibility testing, as well as the patient's medical history and underlying conditions 1.
- Prevention strategies, such as proper hygiene, adequate fluid intake, and urination after sexual activity, can help reduce the risk of developing a UTI 1.
From the Research
Streptococcus in Urine
- Streptococcus in urine can be caused by various species, including Streptococcus agalactiae and Streptococcus bovis 2, 3
- The treatment of urinary infections caused by Streptococcus agalactiae is often successful with antibiotics such as ampicillin, augmentin, and cephalothin 2
- Streptococcus bovis group (SBG) can cause urinary tract infections, and most isolates are susceptible to penicillin, nitrofurantoin, and fosfomycin 3
- In some cases, Streptococcus bovis bacteriuria may be a marker of underlying endocarditis and colorectal cancer 3
- Amoxicillin-clavulanate has been found to be effective in the treatment of urinary tract infections, including those caused by extended-spectrum beta-lactamase-producing Escherichia coli 4, 5, 6
- The use of amoxicillin-clavulanate as an oral therapy may be a useful alternative for the treatment of urinary tract infections, including those caused by Streptococcus species 4, 5, 6