Prophylaxis of recurrent urinary tract infection in female patients. Efficacy of low-dose, thrice-weekly therapy with trimethoprim-sulfamethoxazole

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Abstract
Women (32) 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 6 mo. Six pre-adolescents received 1/2 this dose. During 21.3 cumulative patient-years of prophylaxis, 1 infection due to Streptococcus faecalis and 1 due to a sulfamethoxazole- and trimethoprim-sensitive Escherichia coli occurred, 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. Within 6 mo. of discontinuation of prophylaxis, 21 patients had recurrent infection with a mean time to recurrence of 2.6 mo. One infection recurred 26 wk following prophylaxis with a Proteus mirabilis. Trimethoprim-sulfamethoxazole therapy three times a week was effective for prophylaxis of recurrent urinary tract infections and did not predispose to colonization of infection with trimethoprim-resistant Enterobacteriaceae.

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