Three-Day Treatment of Urinary Tract Infections

Abstract

There is little rationale to support the currently accepted 10-14 day treatment period for urinary tract infection. To assess the cure rate in patients given 3 days compared to the standard 10 day period of antimicrobial therapy a prospective trial was designed to test the over-all effectiveness of each treatment. Sixty patients were randomized to penicillin-G or trimethoprim-sulfamethoxazole for 3 or 10 days. Urine and external vaginal cultures were done before therapy was instituted, at day 3 while on therapy and 7 days after the completion of treatment. The over-all cure rate in the short-term treatment group was 86% and in the long-term treatment group it was 88%. Patients receiving trimethoprim-sulfamethoxazole had a much better response to clearance of the pathogenic bacteria from the external vagina but this did not correlate with clearance of the bladder bacteriuria. Bacterial sensitivities on the external vaginal cultures suggest that in some patients 10 days of therapy actually may aid in the development of bacterial resistance noted in subsequent bladder infections.