Single-dose cephalexin therapy for acute bacterial urinary tract infections and acute urethral syndrome with bladder bacteriuria

Abstract

The efficacy of single-dose therapy with 3 g of cephalexin was evaluated in 129 women with symptoms of acute uncomplicated lower urinary tract infections. Of 91 patients with significant bacteriuria, 61 Urinary tract infections (UTI) affect at least 10% of the female population and are among the most common infections seen in general medical practice during a lifetime. In general, they are easy to diagnose and can be effectively treated with many different antimicrobial agents; however, the dosage and length of treatment are still controversial.Recently, several studies showed that a single-dose regimen is effective in treating acute uncomplicated UTI in a selected population of women (12, 13). However, when unselected populations were studied, the single-dose regimen was less effective (6-8, 10, 11, 16).Henry Ford Hospital is a 950-bed, outpatient, general medical facility in the inner-city area of Detroit with several satellite clinics in the suburbs. Observations of the patients in this institution gave us the opportunity to study different population groups living within the same large metropolitan area. We chose to investigate the efficacy of a single oral dose of cephalexin in treating -acute uncomplicated UTI in women. MATERIALS AND METHODSFemale patients who had symptoms suggestive of acute UTI (dysuria, frequency, hematuria) and had abnormal urinalysis results were entered in the study after informed consent was obtained. We excluded patients who were over 70 years ofage, were pregnant, or showed evidence of hepatic or renal impairment or other concomitant infection. We also excluded patients who had signs of acute pyelonephritis, had recently used antibiotics, or had a history of cephalosporin hypersensitivity or complicated UTI (e. g., nephrolithiasis, indwelling catheter, etc.). Initially, 129 patients were entered * Corresponding author.

Treatment of acute uncomplicated urinary tract infections with 3 days of lomefloxacin compared with treatment with 3 days of norfloxacin

“…The mean age of the subjects enrolled in the Scandinavian study was 45 years, suggesting that a large number of older women were enrolled. Postmenopausal women do less well with short courses of therapy for urinary tract infections (2,7,17), and the high proportion of older women enrolled may explain the observed differences between 3 and 7 days of therapy for that study. In contrast to those from the Scandinavian study, the observations from this and other studies (8,17) suggest that 3 days is likely the optimal duration for quinolone treatment of acute uncomplicated urinary tract infections in young women.…”

Single-dose cefuroxime axetil versus multiple-dose cefaclor in the treatment of acute urinary tract infections

“…Failure of single-dose therapy in UTIs has been attributed to the presence of underlying urinary tract anomalies, upper UTIs, demographic characteristics of the patients, and bacterial resistance to the test drug (2,5,11,14,34,35). In addition, the pharmacokinetic characteristics of the agents used for single doses may have an impact on the outcome of therapy.…”

“…Other advantages of single-dose therapy are lower cost, increased patient compliance, fewer adverse effects, and reduced potential for emergence of resistant bacteria in the gut. However, comparisons of long-term recurrence rates between single-dose therapy and conventional multidose therapy are not available.Cephalosporins have a broad spectrum of antimicrobial activity, but their efficacy in single-dose therapy remains controversial (5,14,32,35). The patient population studied, the types of infections, and the pharmacokinetic characteristics of the tested cephalosporin contribute in part to the conflicting results.…”

“…Cephalosporins have a broad spectrum of antimicrobial activity, but their efficacy in single-dose therapy remains controversial (5,14,32,35). The patient population studied, the types of infections, and the pharmacokinetic characteristics of the tested cephalosporin contribute in part to the conflicting results.…”

Treatment duration for urinary tract infections in adults

“…The latter organism causes the urethral syndrome rather exclusively in young, unmarried, sexually active women who have multiple sexual partners (3). Limited data indicate that low-count bacteriuria can be eradicated by single-dose antimicrobial therapy (8,54).…”