Efficacy of long-term antimicrobial prophylaxis after acute pyelonephritis in Pregnancy

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Abstract
The efficacy of antimicrobial prophylaxis for recurrent urinary infection after an episode of acute febrile pyelonephritis was assessed in 27 pregnant women. Immediately following a 2-week treatment course for acute pyelonephritis, low-dose prophylaxis with a proper antimicrobial agent taken at bedtime daily was continued until 1 month after delivery. 23 women received 50 mg of nitrofurantoin, and 2 each were given 250 mg of amoxycillin and 250 mg of cephalexin, respectively. The treatment regimens were well tolerated and there were no breakthrough infections during a total of 7.8 patient-years of treatment. These results show that long-term low-dose antimicrobial prophylaxis is highly effective in this population at high risk of recurrent acute pyelonephritis.