Management of recurrent urinary tract infections with patient-administered single-dose therapy

• Published in: Annals of internal medicine Vol. 102; no. 3; p. 302
• Main Authors: Wong, E S, McKevitt, M, Running, K, Counts, G W, Turck, M, Stamm, W E
• Format: Journal Article
• Language: English
• Published: United States 01-03-1985
• Subjects: Adolescent; Adult; Costs and Cost Analysis; Drug Administration Schedule; Drug Combinations - administration & dosage; Drug Combinations - adverse effects; Enterobacteriaceae - isolation & purification; Evaluation Studies as Topic; Female; Humans; Male; Random Allocation; Rectum - microbiology; Recurrence; Self Administration - economics; Sulfamethoxazole - administration & dosage; Sulfamethoxazole - adverse effects; Trimethoprim - administration & dosage; Trimethoprim - adverse effects; Trimethoprim, Sulfamethoxazole Drug Combination; Urethra - microbiology; Urinary Tract Infections - diagnosis; Urinary Tract Infections - drug therapy; Urinary Tract Infections - prevention & control; Vagina - microbiology
• ISSN: 0003-4819
• DOI: 10.7326/0003-4819-102-3-302

In a randomized crossover trial, 38 women with recurrent urinary tract infections were assigned to use either continuous prophylaxis with trimethoprim-sulfamethoxazole or intermittent self-administered therapy (single-dose trimethoprim-sulfamethoxazole taken for acute urinary symptoms). The infection rate for patients on prophylaxis was 0.2 episodes/patient-year compared with 2.2 infections/patient-year for patients on self-administered therapy (p less than 0.001). Thirty-five of thirty-eight symptomatic episodes diagnosed by patients as infection were confirmed microbiologically, and 30 of the 35 infections responded clinically and microbiologically to patient-administered therapy with single-dose trimethoprim-sulfamethoxazole. No complications were seen in the 5 patients in whom therapy failed. The annual costs of prophylaxis and self-therapy were similar ($256 and $239, respectively) and both were less expensive than conventional therapy in women having 2 or more infections per year. In selected women, self-therapy is efficacious and economical compared with conventional therapy or prophylaxis.