A comparative trial of co-trimoxazole and cephradine in patients with recurrent urinary infections

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Abstract
A clinical trial comparing co-trimaoxazole and cephradine for the treatment of recurrent urinary infections has been carried out. A 7 day course of treatment was given: 43 patients received co-trimoxazole (2 tablets 12-hourly) and 44 cephradine (500 mg 6-hourly). At 2 weeks the cure rates were: 85.4% for co-trimoxazole and 69.8 % for cephradine. Further assessment at 6 weeks showed a cure rate of 72.5 % for co-trimoxazole and 56% for cephradine. Cure rates for the two drugs did not give a statistically significant difference. Infecting organisms were similar, in species and sensitivity patterns, to those found in simple infections. Side-effects were more common with cephradine (27.3%) than with co-trimoxazole (9.3%), but only 3 patients (2 taking co-trimoxazole, 1 taking cephradine) abandoned treatment because of side-effects. A clear reason for failure of treatment could be found in only half the patients who did not respond. It is concluded that urinary infection in ‘difficult’ patients, such as those treated in this trial, can be managed with conventional dosages of the usual antibacterial agents. Where long-term prophylactic treatment is indicated, this should be started after the two week follow-up has shown the urine to be sterile.

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