Prophylaxis of Recurrent Urinary Tract Infection in Female Patients
Efficacy of Low-Dose, Thrice-Weekly Therapy With Trimethoprim-Sulfamethoxazole
- Godfrey K. M. Harding, MD;
- Frederick J. Buckwold, MD;
- Thomas J. Marrie, MD;
- Linda Thompson, RN;
- R. Bruce Light, MD;
- Allan R. Ronald, MD
- From the Departments of Medical Microbiology and Medicine, University of Manitoba (Drs Harding, Buckwold, Marrie, Light, and Ronald), and the Infectious Disease Service, Health Sciences Centre (Drs Harding, Buckwold, Marrie, Light and Ronald and Ms Thompson), Winnipeg. Dr Buckwold is now in private practice in San Antonio, Tex. Dr Marrie is now with the Department of Medicine, Dalhousie University, and the Department of Microbiology, Victoria General Hospital, Halifax.
Abstract
Thirty-two women with recurrent urinary tract infections were treated after eradication of existing infections with a mixture of 40 mg of trimethoprim and 200 mg of sulfamethoxazole thrice weekly at bedtime for six months. Six preadolescents received one half this dose. During 21.3 cumulative patient-years of prophylaxis, one infection due to Streptococcus faecalis and one due to a sulfamethoxazole- and trimethoprim-sensitive Escherichia coli occured—an infection incidence of 0.1 per patient-year. During prophylaxis, 61 of 72 periurethral cultures and 24 of 51 anal canal cultures failed to yield Enterobacteriaceae. One patient had transient colonization with a trimethoprim-resistant E coli during prophylaxis. Twenty-one patients had recurrent infection within six months of discontinuation of prophylaxis, with a mean time to recurrence of 2.6 months. One infection recurred 26 weeks following prophylaxis with a Proteus mirabilis. Thrice-weekly trimethoprim-sulfamethoxazole therapy was effective for prophylaxis of recurrent urinary tract infections and did not predispose to colonization or infection with trimethoprim-resistant Enterobacteriaceae.
(JAMA 242:1975-1977, 1979)
Footnotes
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Read in part before the 18th Interscience Conference on Antimicrobial Agents and Chemotherapy, Atlanta, Oct 2, 1978.
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Reprint requests to Department of Medical Microbiology, Basic Sciences Building, 730 William Ave, Winnipeg, Manitoba R3E 0Z3, Canada (Dr Harding).
