Single-Day Treatment with Trimethoprim for Asymptomatic Bacteriuria in the Elderly Patient

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Abstract
Recent reports have demonstrated an association between bacteriuria [Escherichia coli, Proteus mirabilis, Klebsiella pneumoniae and Streptococcus faecalis] and excess mortality. Inpatients (40), 60 or more yr old with asymptomatic bacteriuria, participated in a double-blind trial to assess the effect of 1-day treatment with trimethoprim. The patients were allocated randomly to receive 100 mg trimethoprim (20 patients) or placebo (20 patients) to be taken in the morning and evening for 1 day. All patients treated with trimethoprim obtained sterile urine, whereas all patients treated with placebo remained bacteriuric (P < 0.002). No side effects were recorded. Many of the cured patients suffered rapid reinfection. Of the 20 initially cured patients 14 (70%, 95% confidence limits 46-88%) had recurrent bacteriuria after 6 wk, indicating that although this treatment is effective immediately it imparts no long-term effect.