Efficacy and safety of self-start therapy in women with recurrent urinary tract infections.
OBJECTIVE
We evaluated the efficacy of self-start therapy in women with recurrent urinary tract infections.


METHODS
Women with recurrent urinary tract infections received a dip slide urine culture kit and 6 tablets of norfloxacin (400 mg.). At each symptomatic urinary tract infection episode the patient performed a culture and initiated therapy. The culture was returned and the patient was resupplied with another kit and norfloxacin. Patients were seen 5 to 9 days and 4 to 6 weeks after therapy to assess treatment outcome.


RESULTS
A total of 34 women were enrolled in the study and were evaluable for treatment outcomes. Six women followed for 74 months were asymptomatic and 9 followed for 103 months had no infections. A total of 28 women followed for 355 months had 84 symptomatic episodes and 25 had 67 urinary tract infections. Patients had symptomatic episodes at a rate of 2.8 per patient-year (range 0 to 9) and infections at a rate of 2.3 per patient-year (range 0 to 9). The greatest risk of symptoms of infection or infection occurred in the first 3 months and among patients with a higher rate of infection before entering the study. Of the 84 symptomatic episodes 78 (92%) responded clinically. Of 78 cultured episodes 11 (14%) were negative. The remaining 67 cultured documented infections were cured microbiologically 5 to 7 days after therapy. No adverse effects occurred. The annual cost unaccompanied by a symptomatic episode was $86 and $259 if symptomatic episodes occurred.


CONCLUSIONS
Intermittent self-start therapy is effective, safe and economical in women with recurrent urinary tract infections.
Department of Urology, Northwestern University Medical School, Chicago, Illinois, USA.
A J
AJ
Schaeffer
B A
BA
Stuppy
D000328:Adult; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D009643:Norfloxacin / Q000627:therapeutic use*; D012008:Recurrence; D012648:Self Care / Q000191:economics*; D014552:Urinary Tract Infections / Q000175:diagnosis* / Q000188:drug therapy*
D000890:Anti-Infective Agents; D009643:Norfloxacin