Single-Dose Therapy for Cystitis in Women

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Abstract
To the Editor.— I read with interest the article by Dr Hooton et al1entitled "Single-Dose Therapy for Cystitis in Women: A Comparison of Trimethoprim-Sulfamethoxazole, Amoxicillin, and Cyclacillin." As an enthusiast for single-dose antimicrobial therapy for uncomplicated acute bacterial cystitis in women, I was not particularly surprised with the results obtained with amoxicillin and a close relative of this drug, cyclacillin. It is now clear that the results with single-dose penicillins and cephalosporins have not been as good as those following the use of a single dose of either co-trimoxazole (trimethoprim-sulfamethoxazole), trimethoprim alone, or an aminoglycoside. The inferior success rates reported with single-dose ampicillinamoxicillin or the cephalosporins may simply reflect the way these drugs act in killing bacteria within the urinary tract. Unfortunately in the design of this prematurely stopped study by Hooton et al,1there was no group of patients receiving a conventional course of treatment (eg,