Nitrofurantoin versus Trimethoprim for low-dose long-term prophylaxis in patients with recurrent urinary tract infections

Abstract

In a prospective randomized study 38 patients with recurrent urinary tract infections (rUTI) were included to take either 50 mg Nitrofurantoin (n = 19) or 50 mg Trimethoprim (n = 19) as low-dose long-term prophylaxis for half a year. Compliance was checked weekly by Bacillus subtilis spore test strips sent in by mail. The infection rate was reduced from more than three per patient year to 0.01. There were no significant differences between the two groups concerning the recurrence rate (Nitrofurantoin: one rUTI; Trimethoprim: three rUTI) or side effects. Under Nitrofurantoin treatment 3 symptomatic fungal infections occurred. Trimethoprim and Nitrofurantoin are equally suitable for low-dose long-term prophylaxis in rUTI. Surveillance of compliance gives important hints for failure of prophylaxis.

Antimicrobial Pharmacotherapy Management of Urinary Tract Infections in Pediatric Patients

“…Few studies have compared the effectiveness of different antibiotics in preventing recurrent UTIs in children. [93][94][95][96][97] Nitrofurantoin was found to be more effective than trimethoprim-sulfamethoxazole in patients with urological abnormalities and young patients aged 1 to 5 years with normal urinary tract system. 93,94 Other studies that included patients without urinary tract abnormalities showed that nitrofurantoin was as efficacious as trimethoprim, cefixime, and pivmecillinam (an extendedspectrum penicillin, not available in the United States).…”

“…93,94 Other studies that included patients without urinary tract abnormalities showed that nitrofurantoin was as efficacious as trimethoprim, cefixime, and pivmecillinam (an extended-spectrum penicillin, not available in the United States). 95,96 Nitrofurantoin was less tolerable than trimethoprim-sulfamethoxazole and pivmecillinam. 94,95 Belet et al compared the efficacy of trimethoprim-sulfamethoxazole, cefadroxil, and cefprozil in 80 children with normal urinary tract system.…”

Antibiotics for Preventing Recurrent Urinary Tract Infection: Systematic Review and Meta-analysis

“…Six trials studied cinoxacin, an obsolete antibiotic. Patients for the studies were mainly recruited in outpatient clinics (20/23 studies), in 1 study in private practices [ 22 ], and in another study from university students [ 14 ], whereas 1 study did not describe the study setting [ 23 ]. Most studies only included women, while 2 studies also allowed the inclusion of men [ 23 , 24 ].…”

“…Patients for the studies were mainly recruited in outpatient clinics (20/23 studies), in 1 study in private practices [ 22 ], and in another study from university students [ 14 ], whereas 1 study did not describe the study setting [ 23 ]. Most studies only included women, while 2 studies also allowed the inclusion of men [ 23 , 24 ]. The prophylaxis period was 6 months in 13/23 studies, 12 months in 9/23 studies, and 3 months in 1 study [ 25 ].…”

Reinfektionsprophylaxe rezidivierender Harnwegsinfektionen im Kindesalter

“…Durch die abendliche Einmalgabe eines niedrigdosierten Antibiotikums sollen wirksame Urinkonzentrationen über etwa 8 Stunden gewährleistet werden, falls keine Nykturie bzw. Enuresis besteht [30]. Es wird eine Niedrigdosis empfohlen, die ausreichende Urinkonzentrationen bei gleichzeitig niedrigen Serumspiegeln gewährleistet.…”