A total of 10,909 puerperal women from 6 different hospitals were screened for
bacteriuria by culture of voided midstream urine (MSU), and a significant growth was found in 881 patients (8.1%). In 731 cases the urine was reexamined by using suprapubic aspiration (SPA), and in only 354 (48%) of the samples the diagnosis of
bacteriuria was confirmed. The contamination rate of the MSU samples varied from 46 to 69% between the different hospitals, indicating that in the postpartum period positive MSU findings would necessitate more thorough examination in order to confirm the diagnosis of
urinary tract infection. In our study, suprapubic aspiration was found to be a simple and acceptable method without any side effects. Confirmed
bacteriuria occurred in 3.2% of the women. Operative delivery (
Cesarean section,
forceps and vacuum extractor delivery),
epidural anesthesia and bladder catheterization increased the risk of
bacteriuria in the postpartum period. Only 27% of the women with positive bladder urine complained of
dysuria and this symptom was significantly more common in women who had been catheterized. 230 patients with confirmed
bacteriuria with
amoxycillin-sensitive bacterias participated in a randomized short-course treatment trial: 114 women received 3 days treatment with
amoxycillin (1.5 g/day), 116 received the traditional 10 days
therapy (750 mg
amoxycillin/day). Both
antibiotic regimens were observed to be effective with a cure rate of 96 and 98%, respectively. Short-course
antibiotic treatment should thus be recommended to puerperal women with
urinary tract infections since this avoids prolonged
drug exposure to the lactating mother.