SummaryA study of placebo treatment of acute symptomatic urinary tract infection in non-pregnant women showed that about 80%4 obtained sterile urine spontaneously within 5 months. About one-half of these had recurrent infection within a year.Antimicrobials produced a high immediate cure rate, but only 45°o maintained sterile urine for 2 years. The recurrence rate was highest during the first 2 months after treatment, and thereafter nearly constant during the subsequent 20 months. Twentynine percent of recurrences were recrudescences and 71%4 reinfections. About one-sixth of the patients had a very high recurrence rate, 2-6 infections/year, as compared with 0*32/year in the remainder. Nearly all of these patients had their first recurrence within 5 months of the initial treatment. The probability of recurrence increased with the number of previous infections. Some patients, however, after a period with many recurrences, showed a remarkable decrease in recurrence rate.If the aim of treatment is to keep periods of bacteriuria to a miniimum, it is necessary to do frequent urine cultures for at least 6 months after elimination of bacteriuria.
IntroductionThe reasons why some, but not all, apparently healthy women acquire urinary tract infection are still not known, and causal treatment is not possible. In orderto relieve discomfort, prevent septicaemia and, if possible, progressive renal damage in bacteriuric patients, efforts are directed towards sterilization of the urinary tract. Innumerable studies have shown that this can be done by appropriate use of antimicrobial therapy. But it is difficult to evaluate whether treatment significantly alters the course of urinary tract infection in women.In the present study a follow-up was made on non-pregnant women with uncomplicated urinary tract infection, in order to get an impression of the outcome of short-term therapy and the possibilities of reducing periods with bacteriuria.
Doctors need to be aware that patients possess such imaginative and experiential resources to make sense of medical explanations. Attempts to draw patients radically away from these resources may cause confusion and undesired breakdowns in the communication between them and their physician.
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