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Effect of asymptomatic bacteriuria treatment prior to total hip or knee arthroplasty on hospital outcomes: A retrospective cohort study

Peters, Michael J. PharmD, BCPS; Twilla, Jennifer PharmD, BCPS; Swanson, Heather R. MD; Jacobs, Anna PharmD, BCPS

doi: 10.1097/BCO.0000000000000806
Original Research

Background: Although treatment of asymptomatic bacteriuria (ASB) in patients undergoing total hip (THA) or knee (TKA) arthroplasty does not seem to effect the rate of secondary joint infections (SJI), the effect on hospital outcomes has yet to be evaluated. This study aimed to determine the clinical effect of ASB treatment in TKA or THA on hospital outcomes.

Methods: A retrospective evaluation of patients undergoing TKA or THA with the presence of ASB was conducted. Inclusion criteria were TKA or THA and presence of ASB. Patients were excluded if symptomatic, receiving nonspecified antibiotics, catheterized, or pregnant. The primary outcome was comparing differences in time from admission to TKA or THA procedure in groups treated for ASB versus an untreated group. Secondary outcomes were length of stay (LOS) and rates of SJI.

Results: A total of 1683 patients were screened, and 133 patients with ASB were included (53 treated; 80 untreated). Median time from admission to procedure was not statistically different between groups (3.63 hr [3.10-5.57 hr] treated vs. 3.68 hr [3.07-5.17 hr] untreated; P=0.412). An increase in LOS was observed in the treated group (3.4 days [3.15-4.36 days] treated vs. 2.36 days [2.21-3.35 days] untreated; P<0.0001). Rates of SJI were not different between groups (P=0.646).

Conclusions: Although time from admission to TKA or THA procedure was not different between groups, a longer LOS was identified in the treated group. There was no difference in rates of SJI between groups. Larger studies are needed to determine if treating ASB for TKA or THA should be discontinued.

Level of Evidence: Level III.

Methodist University Hospital, Memphis, TN

Financial Disclosure: The authors report no conflicts of interest.

Correspondence to Michael J. Peters, PharmD, BCPS, Methodist University Hospital, 1265 Union Avenue, Memphis, TN 38104 Tel: +260-494-4908; fax: +901-516-8178; e-mail:

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