Dawaa Reference

infectious

Asymptomatic Bacteriuria (Pregnancy)

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources3 sources

Egyptian National Drug Formulary - Antimicrobial 2023 · Monuril 3g granules for oral solution SmPC sections 4.1-4.2 (eMC product 7329) · UTI and asymptomatic bacteriuria in pregnancy - disease-level clinical article (uti-in-pregnancy-full.txt)

Verified against3 documents
  • Egyptian National Drug Formulary - Antimicrobial 2023
  • Monuril 3g granules for oral solution SmPC sections 4.1-4.2 (eMC product 7329)
  • UTI and asymptomatic bacteriuria in pregnancy - disease-level clinical article (uti-in-pregnancy-full.txt)

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (1)

  • By definition, no urinary symptoms are present despite bacteria in the urine

Tests (7)

  • Diagnosis requires a urine culture, either clean-catch or catheter specimen
  • In women, two consecutive clean-catch specimens with the same organism at 100,000 CFU/mL or more confirm the diagnosis
  • In men, one clean-catch specimen with a single organism at 100,000 CFU/mL or more is diagnostic
  • A catheterized specimen needs only 100 CFU/mL or more of a single organism to confirm the diagnosis
  • Leukocyte esterase on dipstick detects pyuria reliably but is not specific for bacteriuria
  • Combining leukocyte esterase and nitrite dipstick testing is more specific than either alone
  • Pregnant women should be screened with a urine culture around the end of the first trimester

If not this — what else fits (6)

  • Acute pyelonephritis as the true diagnosis
  • Chlamydial genitourinary infection
  • Nonbacterial cystitis
  • Interstitial cystitis
  • Pelvic inflammatory disease
  • A renal or perirenal abscess

SourceStatPearls "Asymptomatic Bacteriuria" - disease-level clinical article

Presentation findings are traced to the source above.

1

NITROFURANTOIN

1st line

Strength100 mg

Formoral.solid

Adult dose and duration

100 mg twice daily (modified-release) for 7 days in pregnant women with positive screening urine culture x 7 days

Paediatric dose

Adult-only condition - paediatric section not applicable

Choice

Alternatives. Nitrofurantoin is the narrow-spectrum first-line agent for bacteriuria in pregnancy; co-amoxiclav is kept as the broader alternative. Avoid nitrofurantoin at term.

Dose source

Egyptian National Drug Formulary - Antimicrobial 2023

Why

Urinary antiseptic that concentrates in the urine to clear asymptomatic bacteriuria in pregnancy; treating it matters because, left alone, it raises the risk of pyelonephritis and preterm labor. Avoided close to delivery for the reason already noted in the cautions.

Cautions
  • Screening and treating asymptomatic bacteriuria is indicated ONLY in PREGNANT WOMEN and prior to traumatic urological procedures.
  • CONTRAINDICATED at term (36-42 weeks pregnancy) due to risk of neonatal hemolytic anemia.
  • Avoid in renal impairment (eGFR <45 mL/min).
Egyptian brands
Egyptian brandManufacturerIndicative price
COLIFURAN 100 MG 20 TABS.KAHIRA2.40 EGP (0.12/unit)
UVAMINE RETARD 100 MG 20 CAPS.MUP > ACINO47.00 EGP (2.35/unit)
MEPAFURAN 100 MG 20 CAPS.MEPACO54.00 EGP (2.70/unit)
MACROFURAN 100 MG 30 CAPS.KAHIRA82.00 EGP (2.73/unit)
2

AMOXICILLIN + CLAVULANIC ACID

1st line

Strength625 mg

Formoral.solid

Adult dose and duration

500/125 mg three times daily (or 875/125 mg twice daily) x 7 days

Paediatric dose

Adult-only condition - paediatric section not applicable

Dose source

Egyptian National Drug Formulary - Antimicrobial 2023

Why

Broad-spectrum penicillin and beta-lactamase inhibitor combination used as an alternative to nitrofurantoin for asymptomatic bacteriuria in pregnancy, chosen when nitrofurantoin is unsuitable or culture sensitivities favor it; the formulary rates it Pregnancy Risk Factor B.

Cautions
  • The Egyptian formulary rates it Pregnancy Risk Factor B and says nothing about individual trimesters. On breastfeeding it is specific: amoxicillin/clavulanate may be used while breastfeeding, with care, at the doses usually recommended, and the infant watched for gastrointestinal upset - thrush and diarrhoea in particular.
  • Check urine culture sensitivity results.
Egyptian brands
Egyptian brandManufacturerIndicative price
AUJED 625 MG 12 F.C. TAB.SIGMA TEC > JEDCO INT. CO. FOR PHARMACEUTICALS19.20 EGP (1.60/unit)
E-MOXCLAV 625MG 10 TAB.EIPICO30.00 EGP (3.00/unit)
DEXICLAVE 625 MG 12 F.C. TABS.RAMEDA > NOVELL PHARMA37.50 EGP (3.12/unit)
MAGNABIOTIC 625MG 8 TAB.SEDICO37.00 EGP (4.62/unit)
CLAVIMOX 625 MG 12 F.C.TABS.PHARCO107.00 EGP (8.92/unit)
CURAM 625MG 12 F.C.TAB.SANDOZ > NOVARTIS108.00 EGP (9.00/unit)
AUGMENTIN 625 MG 10 F.C.TABS.MUP > SMITHKLINE BEECHAM117.00 EGP (11.70/unit)
CLAVOCILLIN 625 MG 10 DISPERSIBLE TABS.RAMEDA > ORGANOPHARMA31.50 EGP
LARYNCLAVE 125/31 PD. FOR ORAL SUSP. 70ML? strength differs? different route - not oral solidMISR > AL ROWAD PHARMACEUTICAL INDUSTRIAL CO.8.00 EGP
MEGACLAVOX 156MG/5ML PD. FOR SUSP. 60 ML? strength differs? different route - not oral solidCID8.00 EGP
3

FOSFOMYCIN

2nd line

Strength3000 mg

Formoral.solid

Adult dose and duration

Fosfomycin 3 g orally once. Dissolve the sachet in a glass of water and take it immediately, on an empty stomach - about 2-3 hours before or after a meal - preferably before bedtime and after emptying the bladder. - single dose

Paediatric dose

Adult-only condition - paediatric section not applicable

Dose source

UTI and asymptomatic bacteriuria in pregnancy - disease-level clinical article (uti-in-pregnancy-full.txt)

Why

Urinary antiseptic valued in pregnancy for how simple the course is to complete, making it a useful alternative to nitrofurantoin or amoxicillin-clavulanate when finishing a longer antibiotic course is a concern.

Cautions
  • The Monuril label's own indications are acute uncomplicated cystitis and prostate-biopsy prophylaxis; it does not name asymptomatic bacteriuria. The indication and the 3 g single dose come from the pregnancy UTI article, and the label supplies only how to take the sachet.
  • Not recommended by the label in renal impairment with creatinine clearance below 10 ml/min.
  • Fosfomycin is a reasonable option for asymptomatic bacteriuria, though it may be less effective for cystitis than a multi-day regimen.
  • The label does not say it is safe in pregnancy - it says Monuril "should only be used during pregnancy, if clearly necessary" (<meta name="description" content="Monuril 3g granules for oral solution SmPC, eMC product 7329), on limited first-trimester data in 152 women, with no teratogenicity signal so far.
Egyptian brands
Egyptian brandManufacturerIndicative price
FOSFORON 3GM 1 SACHETGLOBE INTERNATIONAL PHARMACEUTICALS39.00 EGP
MONURIL 3GM 1 SACHETZAMBON > PHARMACON293.00 EGP

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.