Management of recurrent urinary tract infections with patient-administered single-dose therapy.
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.
D000293:Adolescent; D000328:Adult; D003365:Costs and Cost Analysis; D004334:Drug Administration Schedule; D004338:Drug Combinations / Q000008:administration & dosage / Q000009:adverse effects; D004755:Enterobacteriaceae / Q000302:isolation & purification; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008297:Male; D011897:Random Allocation; D012007:Rectum / Q000382:microbiology; D012008:Recurrence; D012646:Self Administration / Q000191:economics; D013420:Sulfamethoxazole / Q000008:administration & dosage* / Q000009:adverse effects; D014295:Trimethoprim / Q000008:administration & dosage* / Q000009:adverse effects; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D014521:Urethra / Q000382:microbiology; D014552:Urinary Tract Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000517:prevention & control; D014621:Vagina / Q000382:microbiology
D004338:Drug Combinations; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D014295:Trimethoprim; D013420:Sulfamethoxazole