Rational Pharmacotherapy of Asymptomatic Bacteriuria in Pregnant Women

Introduction. Asymptomatic bacteriuria (AB) refers to the category of pathological conditions that are caused by the infection of the urinary tract and are in particular importance for pregnant women, as in the case of late diagnosis or inadequate treatment in 20.0–40.0 % of cases they realizes in gestational pyelonephritis and becomes one of the factors of the development of intrauterine infection. Aim. To study the results of the use of Nefrokea in the treatment of AB in pregnant women. Materials and methods. The study group was made up of 60 women for whom, during the first trimester of pregnancy, during the first visit to the physician, the bacteriological examination of the urine received by the catheter was made and showed an increase of bacterial cultures in the urine (≥ 105 CFU/ml), on the basis of which it was diagnosed AB. The study group included 30 patients who, after the diagnosis of AB, took amoxicillin (500.0 mg twice daily for 5-7 days) and Nefrokea (1 tablet per day for 30 days). To compare clinical results, a control group of 30 pregnant women with AB, who was prescribed antibiotic therapy, was created. At the end of treatment, a urine culture study was performed, after what nephrologist and therapist conducted a clinical examination. Results. The efficacy of AB treatment during the pregnancy in this study was evaluated within 4-12 weeks from the time of diagnosis and onset of treatment. The results showed in the study group the normalization of the results of bacteriological and general urine analysis after the first course of treatment in 73.3% of pregnant women (in the control group – 63.3% of pregnant women, which is almost 1.2 times less). At the same time, the results of fetometry showed that the size of the fetus was normal for a gestational period (16-18 weeks), and during the echography of the kidney of pregnant women, no pathological changes were recorded. 26.7% of the patients in the main and 36.7% of the controls revealed the recurrence of the AB and prescribed a re-treatment course according to the abovementioned schemes. The use of Nefrokea's herbal compound in the complex treatment of pregnant women with AB showed its high efficacy, good tolerability, reduction in the incidence of gestational pyelonephritis by 2.5 times, other obstetric complications (fetal growth retardation syndrome, premature births) twice. Taking into account the high incidence of urinary tract infections during the second trimester of pregnancy, we consider that it is advisable to prescribe Nefrokea to women with diabetes mellitus with 11-12 weeks of pregnancy with a preventive and curative purpose. Conclusions. The usage of the herbal remedy Nefrokea in the treatment of asymptomatic bacteriuria helpes to reduce the incidence of pyelonephritis and associated obstetric complications.