1. Home>
2. Specialties>
3. General Medicine>
4. Summary and Comment

PROPHYLACTIC CIPROFLOXACIN FOR RECURRENT UTI.

Occasionally we resort to prophylactic therapy for women with recurrent urinary tract infections (UTIs). This randomized study examined outcomes with ciprofloxacin prophylaxis in 135 sexually active premenopausal women with at least three documented lower UTIs in the preceding 12 months. One group received a daily 125 mg dose of ciprofloxacin, while the other group took the drug only after intercourse (on average, twice a week).

The two regimens were equally effective during one year of prophylaxis: only two women from each group had a symptomatic UTI. Two isolates from the patients with UTIs were resistant to ciprofloxacin. During the next 12 months (after prophylaxis was discontinued), the incidence of UTI climbed to 0.44 episodes per patient-year. This rate was much higher than the rate during prophylaxis (0.04 per patient-year), but much lower than the rate prior to prophylaxis (3.6 episodes per patient-year). Four postcoitally treated patients and nine daily treated patients had drug side effects.

Comment: Postcoital UTI prophylaxis with ciprofloxacin is as effective as daily dosing, and presumably is less likely to cause side effects. Nevertheless, to minimize the emergence of drug-resistant pathogens, we probably should reserve prophylactic therapy for the minority of women who are most incapacitated by recurrent UTI.

— AS Brett

Published in Journal Watch General Medicine March 11, 1997

Citation(s):

Melekos MD et al. Post-intercourse versus daily ciprofloxacin prophylaxis for recurrent urinary tract infections in premenopausal women. J Urol 1997 Mar 157 935-939.

• Medline abstract (Free)