POST-INTERCOURSE VERSUS DAILY CIPROFLOXACIN PROPHYLAXIS FOR RECURRENTURINARY-TRACT INFECTIONS IN PREMENOPAUSAL WOMEN

Purpose: We evaluated and compared the efficacy of post-intercourse an d daily oral ciprofloxacin prophylaxis against recurrent lower urinary tract infections in 135 sexually active premenopausal women. Material s and Methods: Post-intercourse (group 1, 70 patients) and daily (grou p 2, 65 patients) prophylactic regimens of 125 mg. ciprofloxacin were started following a curative, conventional treatment of the initial ac ute urinary tract infection. Prophylaxis was maintained for 12 months and during this period patients were followed clinically and bacteriol ogically with urine and introital samples. Patients were subsequently followed for an additional year after the end of preventive treatment. Results: While 3.67 urinary tract infections per patient in group 1 a nd 3.74 in group 2 occurred during an identical mean time of 12.2 mont hs before start of the corresponding prophylactic regimen, only 0.043 infection per patient in group 1 and 0.031 in group 2 developed during prophylaxis (p < 0.0001). Before prophylaxis 86% of the vaginal vesti bule cultures yielded gram-negative Enterobacteriaceae, equally distri buted between both treatment arms, compared to 5.6% and 2.5% during po stcoital and daily prophylaxis, respectively. The overall improvement in the incidence of the urinary infections per patient and the rate of introital colonization with enteric gram-negative bacteria was mainta ined after the end of prophylaxis, with a mean incidence of infections of 0.44 per patient (occurring in 34% of the total patient population ), while 36% of all women had abnormal introital colonization. Conclus ions: 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 c onsumed in daily prophylaxis.