Background: There is no clear recommendation on the treatment duration of asymptomatic bacteriuria (AB) after kidney transplantation (KT).  A 10 to 14 day-course of antibiotics has generally been practiced in some transplant centers, however a longer treatment duration might result in an unnecessary use of antibiotics without different outcomes. Methods: A randomized open-label pilot study among hospitalized patients who had AB within 1 month after KT from March 2015 to February 2016 was conducted.  Intervention and control groups received a 7-day and 14-day course of antibiotic treatments, respectively. The primary outcome was the occurrence of symptomatic urinary tract infection (UTI) and/or urosepsis within 3 months after treatment discontinuation. Results: Twenty patients were enrolled with a median age of 43 (IQR, 36-52) years and 75% were female.  Eight (40%) patients underwent living-related KT and 4 (20%) patients received anti-thymocyte globulin for induction therapy.  Patients were randomized into intervention (n=9, one withdrew consent) and control group (n=10).  Symptomatic UTI and/or urosepsis within 3 months after treatment was not significantly different between the two groups [22.2% in intervention vs.10% in control group; hazard ratio, = 2.67, 95% confidence interval, 0.24-29.92; p = 0.43]. There was no difference in length of stay, rate of recurrent UTI and allograft dysfunction at 3 months.  However, one patient in the intervention group experienced recurrent UTIs and allograft loss. Conclusion: This pilot study suggests that a short duration of antibiotics for AB early after KT might not lead to a higher complication.