Portal de Periódicos da CAPES

Prophylactic Efficacy of Nitrofurantoin Macrocrystals and Trimethoprim-Sulfamethoxazole in Urinary Infections

1977; Massachusetts Medical Society; Volume: 296; Issue: 14 Linguagem: Inglês

10.1056/nejm197704072961403

1533-4406

Thomas A. Stamey, Mercy Condy, Gladys Mihara,

Antibiotic Use and Resistance

We examined bacterial persistence and resistance in the vaginal and fecal flora of 28 women who received a total of 253 months of daily low-dosage prophylaxis with nitrofurantoin macrocystals (100 mg per day) or trimethoprim–sulfamethoxazole (40 and 200 mg respectively). During trimethoprim–sulfamethoxazole prophylaxis, 8.5 per cent of monthly vaginal and 27 per cent of monthly fecal cultures grew Escherichia coli, as compared to 36 and 96 per cent, respectively, for nitrofurantoin macrocrystals. Esch. coli resistant to nitrofurantoin occurred in two of 95 fecal cultures during therapy, and Esch. coli resistant to trimethoprim–sulfamethoxazole in 16 of 182 (8.8 per cent) fecal cultures. In the 12 months before treatment, 92 episodes of recurrent urinary infection occurred, as compared to six during treatment (none occurred on trimethoprim–sulfamethoxazole). These results confirm the value of trimethoprim–sulfamethoxazole prophylaxis for high-risk patients with recurrent urinary infections. Prophylaxis with nitrofurantoin macrocrystals seems adequate for less severe problems of reinfection. (N Engl J Med 296:780–783, 1977)