Post-Intercourse Versus Daily Ciprofloxacin Prophylaxis for Recurrent Urinary Tract Infections in Premenopausal Women

Melekos, Michael D.; Asbach, H. W.; Gerharz, Elmar W.; Zarakovitis, Ioannis E.; Weingaertner, Karl; Naber, Kurt G.

doi:10.1097/00005392-199703000-00052

Cited by 7 publications

(7 citation statements)

References 21 publications

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“…A long-term prevention treatment lasting 6 months to 1 year has been recommended [7]. In the last decade, antimicrobial agents such as trimethoprim, co-trimoxazole, nitrofurantoin, and quinolones, proved effective in the long-term prophylactic treatment of re- current UTIs [18,19]; however, the emergence of uropathogen strains with resistance to well established antibacterial drugs represent a reason of concern. In the US, more than 20−25 % of E. coli, responsible for cystitis, showed bacterial resistance against amoxycillin, cephalexin, and sulpha drugs; the combination of trimethoprim with sulphamethoxazole (co-trimoxazole) is approaching this level of resistance.…”

Section: Introductionmentioning

confidence: 99%

Prevention of Recurrent Lower Urinary Tract Infections by Long-term Administration of Fosfomycin Trometamol

Rudenko

Dorofeyev

2011

Arzneimittelforschung

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Three hundred and seventeen non pregnant females, suffering of recurrent lower urinary tract infections (UTIs; at least three episodes in the preceding 12 months) were enrolled in a double blind, randomized placebo (PL) controlled, parallel group clinical study, addressed to evaluate the efficacy and safety of fosfomycin trometamol (CAS 78964-85-9, FT, Monuril) in the prevention of infectious recurrences of lower urinary tract. One hundred and sixty six and 151 patients were allocated at random to FT or to PL treatment. The assigned treatment, i.e. one sachet containing FT equivalent to 3 g. of fosfomycin or PL, was taken by patients every 10 days during 6 months; thereafter they were followed up for another 6 consecutive months. Three hundred and two evaluable patients, completed the study as per protocol, 158 in the FT and 144 in the PL group, respectively. The analysis of the number of urinary tract infections/patient-year (primary end point) showed a result of 0.14 infections/patient-year in the FT group and of 2.97 infections/patient-year in the PL group. The difference was highly significant (p < 0.001). The time to first infection recurrence was significantly longer in the FT (38 days) than in the PL group (6 days); p < 0.01. The number of patients with at least one episode of recurrent infection and the number of episodes/patient during the treatment as well as during the follow-up period were statistically significantly lower in the FT group than in the PL group. Both treatments were well tolerated; only one adverse reaction possibly treatment related, i.e. an allergic skin reaction, was reported in both groups. Haematology and blood chemistry variables explored for safety at the end of the study did not show any significant difference between the two groups. The compliance with the treatment in the 302 evaluable patients was excellent. The results of this trial indicate that FT is higly effective in the prophylaxis of UTI recurrences; this beneficial effect is evident also in the 6 months of the follow-up.

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Section: Introductionmentioning

confidence: 99%

Prevention of Recurrent Lower Urinary Tract Infections by Long-term Administration of Fosfomycin Trometamol

Rudenko

Dorofeyev

2011

Arzneimittelforschung

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“…In a randomised study comparing daily prophylactic with post-coital ciprofloxacin in sexually active women, there was no detectable difference between the two groups. 43 The rates of side effects were also not significantly different.…”

Section: Prophylactic Antibioticsmentioning

confidence: 86%

Contemporary Management of recurrent UTI in adult females

Christofides

Swallow

Parkinson

2013

Journal of Clinical Urology

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The management of recurrent UTI is subject to significant variation and patients may fall under the care of a variety of specialties. We review the pathogenesis, investigation and management of this group of patients. Accurate diagnosis of UTI is the cornerstone of successful management, and careful interpretation of MSU results is needed. Although prophylactic antibiotic regimes are often successful, the emergence of antibiotic resistance mandates the cautious use of antibiotics and consideration of other initial therapies where possible.

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“…Post-coital antibiotics reduce the rate of UTI in women with coitally-associated UTI. 68,69 When there is no post-coital association with rUTI, daily continuous antibiotic prophylaxis for 6-12 months reduces UTI risk compared with placebo. 70 When rUTI episodes continue despite the previously described prevention strategies have failed, intravesical antibiotic instillations can be used.…”

Section: Preventionmentioning

confidence: 99%

The etiology and management of recurrent urinary tract infections in postmenopausal women

Jung

Brubaker

2019

Climacteric

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Urinary tract infections (UTI) are one of the most common infections and affect up to 50% of women in their lifetime, with almost half of these women experiencing a recurrence in 6-12 months. Menopause predisposes women to rUTI, as normally lower levels of estrogen lead to changes in the urogenital epithelium and subsequently urogenital microbiome. The recently discovered urobiome is now known to have different compositions in both healthy and unhealthy bladders, including a role in the pathophysiology of rUTI, and may be a therapeutic target for prevention and treatment options for rUTI. In postmenopausal women with frequent UTI, the diagnosis of acute UTI should be made using a combination of the symptom assessment and urine diagnostic studies. The choice of UTI antibiotic should include consideration of efficacy, collateral effects, and side effects. Some women may be candidates for self-start therapy, in which the patient accurately recognizes her UTI symptoms and then starts previously prescribed antibiotics. A large component of the management of women with rUTI is prevention. Urobiome research for bladder health and disease is a young field of investigation with significant potential to improve care for postmenopausal women affected by rUTI through novel, evidence-based prevention and treatment strategies.

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Post-Intercourse Versus Daily Ciprofloxacin Prophylaxis for Recurrent Urinary Tract Infections in Premenopausal Women

Abstract: Long-term post-intercourse prophylaxis with ciprofloxacin proved to be equally effective as daily prophylaxis, and the major advantage of the former therapy was use of only a third of the amount of drug consumed in daily prophylaxis.

Cited by 7 publications

References 21 publications

Prevention of Recurrent Lower Urinary Tract Infections by Long-term Administration of Fosfomycin Trometamol

Prevention of Recurrent Lower Urinary Tract Infections by Long-term Administration of Fosfomycin Trometamol

Contemporary Management of recurrent UTI in adult females

The etiology and management of recurrent urinary tract infections in postmenopausal women

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