Postcoital prophylaxis for urinary tract infection - Tips from Other Journals

Date: Dec, 1990

Antibiotic prophylaxis is beneficial in the management of recurrent urinary tract infections in young women. However, because of cost, inconvenience, side effects and problems with patient compliance, other strategies need to be explored. Stapleton and colleagues evaluated the use of prophylactic antibiotics only after sexual intercourse in a placebo-controlled study.

Female university students with at least two documented urinary tract infections in the previous year were eligible for the study. Sixteen of the women were' randomized to receive one dose of trimethoprim-sulfamethoxazole (40 mg/200 mg) within two hours of sexual intercourse, and 11 received placebo. The subjects in the two groups were similar with respect to age, race, marital status, gravidity, diaphragm use, history of urinary tract infections, frequency of sexual intercourse and number of lifetime sexual partners.

The patients were seen two weeks following entry into the study and then at monthly intervals for six months while receiving therapy. All of the patients were required to keep a daily record of frequency of sexual activity, medications taken and occurrence of side effects. Diary documentation of tablets taken was used to assess compliance.

While nine of the 11 women using placebo developed urinary tract infections during the study period, only two of the 16 women taking postcoital trimethoprim-sulfamethoxazole developed urinary tract infections. The difference in infection rates (0.3 versus 3.6 infections per patient-year) was statistically significant. Few side effects were reported.

The study findings indicate that postcoital administration of trimethoprimsulfamethoxazole may be useful in the management of recurrent urinary tract infections in young women. JAMA, August 8, 1990, vol. 264, p. 703.)

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