A total of 102 women with recurrent urinary tract infections were included in this open randomized study; 55 received 200 mg of norfloxacin daily and 47 received 50 mg of nitrofurantoin daily over 6 months. Fifty-three and 41 women from the norfloxacin-and nitrofurantoin-treated groups, respectively, completed the 6-month follow-up period. Forty-four (81%) of the norfloxacin-treated patients and 27 (65%) of the nitrofurantointreated patients remained free of symptoms (P = 0.05), and urine samples from 49 (92.4%) and 29 (70.7%) of the patients, respectively, were sterile (P < 0.005). Side effects occurred with similar frequencies in both groups (15 and 17%) but were more severe in the women who received nitrofurantoin. Despite the better results obtained with norfloxacin, the difference in the costs of the two agents must be considered.Recurrent urinary tract infection (UTI) is a common problem affecting approximately 6 to 10% of women of all ages. Most of those affected have a normal urogenital tract, and most of the infections are caused by recurrent colonization of the periurethral area by microorganisms from the intestinal flora with subsequent ascension to the bladder (6).Effective antibiotic regimens to prevent recurrent UTIs have used low doses of trimethoprim-sulfamethoxazole, trimethoprim alone, nitrofurantoin, and cephalosporins over a prolonged period of time (5).The new fluoroquinolones are ideal agents for the treatment of UTIs because of their broad-spectrum activity against most uropathogens and their ability to achieve high levels in the urinary tract. Numerous studies have shown their efficacy in the treatment of complicated and uncomplicated UTIs (1, 7), but few studies have evaluated their effectiveness as prophylactic agents (3, 4).The present study was designed to evaluate the efficacy and safety of prolonged use of a low dose of norfloxacin and to compare these results with those obtained with a prolonged treatment with nitrofurantoin in the prevention of recurrent UTI in women. A feature of this study is the inclusion of women with recurrent UTIs who had different diseases, urinary or gynecological abnormalities, and menstrual status of the patients were recorded. Pregnant women and those who were planning pregnancy were excluded.A clear-voided midstream urine specimen was collected from each patient and cultured with the Uritest system (Nylab dip slides; Rehovot, Israel). Once a negative urine culture was obtained, the women were randomized by an open schedule into two groups: one group received 200 mg of norfloxacin nightly and the second group received 50 mg of nitrofurantoin nightly. Both groups were treated for 6 months.All patients were seen once a month or when symptoms relating to UTIs appeared. Urine cultures were performed on each visit, and clinical bacteriological infections were recorded. Hematological, liver, and renal function tests were performed before initiation of treatment and at 2, 4, and 6 months after treatment began. All possible drug-related side effects were also r...

In a double-blind randomized study we compared a single-dose amoxicillin-clavulanate combination with a regular 3-day regimen in 109 women with cystitis. Clinical cure rates at 7 and 28 days posttreatment were 78 versus 87% and 67 versus 78%, respectively. The 3-day regimen was significantly better (P <0.001) only in women with recurrent urinary tract infections.The preferred treatment for uncomplicated cystitis in nonpregnant women is controversial. Single-dose regimens have been shown to be as effective as 7-to 10-day courses (10). The advantages of single-dose therapy include lower cost, better compliance, fewer side effects, and a diminished pressure on the intestinal and vaginal flora (4). However, several studies have shown that the rate of recurrent infection following single-dose treatment is significantly higher than after longer courses (8,9 clavulanic acid disk was used for susceptibility testing, and a zone diameter of less than 19 mm was considered to be indicative of resistance.Treatment was given on a randomized and double-blind basis. Women in the single-dose group received five caplets of amoxicillin (500 mg each) plus one caplet of augmentin containing 500 mg of amoxicillin plus 125 mg of clavulanic acid. This was followed by single placebo caplets every 8 h for 3 days. Women in the second group received one caplet of augmentin containing 250 mg of amoxicillin plus 125 mg of clavulanic acid and five placebo caplets; this was followed by augmentin (250 mg) every 8 h for 3 days. Each patient was monitored clinically and bacteriologically at 7 and 28 days. Women with persistent bacteriuria and sensitive organisms were further evaluated by intravenous pyelogram or renal ultrasound.Statistical analysis was performed by the chi-square test with Yates' correction where appropriate, and P values of <0.005 were considered statistically significant.A total of 109 patients completed the treatment and both follow-up points; 55 received the single-dose regimen, and 54