Cephalexin for susceptible bacteriuria in afebrile, long-term catheterized patients
J. W. Warren, W. C. Anthony, J. M. Hoopes and H. L. Muncie Jr
Patients with long-term indwelling urethral catheters are subject to acute
and long-term complications of bacteriuria. To evaluate the common practice
of short-course antibiotic therapy in such patients, we performed a
randomized controlled trial of ten-day courses of cephalexin monohydrate
repeated whenever a susceptible bacteriuria was present. We observed 17
cephalexin group patients for 545 patient-weeks (160 cephalexin courses)
and 18 control group patients for 477 patient-weeks. Throughout the study,
the groups were comparable in regard to incidence and prevalence of
bacteriuria, number of bacterial strains per weekly urine specimen,
incidence of febrile days, and incidence of obstructed catheters. In the
cephalexin group, the frequency of fever during periods when antibiotics
were being used was similar to that during periods when antibiotics were
not being used. More cephalexin-resistant bacteria were isolated from
cephalexin group patients. Routine treatment with cephalexin of
asymptomatic long-term catheterized patients, even for susceptible
organisms, does not seem to be warranted.
