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Management of Recurrent Urinary Tract Infections with Patient-Administered Single-Dose Therapy

EDWARD S. WONG, M.D.; MARY McKEVITT, R.N., B.S.; KATE RUNNING, P.A., W.H.C.S.; GEORGE W. COUNTS, M.D.; MARVIN TURCK, M.D.; and WALTER E. STAMM, M.D.
[+] Article and Author Information

Grant support: in part by AI 18205 and AI 12192 from the National Institute of Allergy and Infectious Diseases.

▸Requests for reprints should be addressed to Walter E. Stamm, M.D.; Department of Medicine, Harborview Medical Center, 325 Ninth Avenue; Seattle, WA 98104.


Seattle, Washington


© 1985 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1985;102(3):302-307. doi:10.7326/0003-4819-102-3-302
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In a randomized crossover trial, 38 women with recurrent urinary tract infections were assigned to use either continuous prophylaxis with trimethoprim-sulfamethoxazole or intermittent self-administered therapy (single-dose trimethoprim-sulfamethoxazole taken for acute urinary symptoms). The infection rate for patients on prophylaxis was 0.2 episodes/patient-year compared with 2.2 infections/patient-year for patients on self-administered therapy (p < 0.001). Thirty-five of thirty-eight symptomatic episodes diagnosed by patients as infection were confirmed microbiologically, and 30 of the 35 infections responded clinically and microbiologically to patient-administered therapy with single-dose trimethoprim-sulfamethoxazole. No complications were seen in the 5 patients in whom therapy failed. The annual costs of prophylaxis and self-therapy were similar ($256 and $239, respectively) and both were less expensive than conventional therapy in women having 2 or more infections per year. In selected women, self-therapy is efficacious and economical compared with conventional therapy or prophylaxis.

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