EFFECTIVE POSTCOITAL QUINOLONE PROPHYLAXIS OF RECURRENT URINARY-TRACTINFECTIONS IN WOMEN

A total of 33 sexually active, premenopausal and postmenopausal women, suffering from recurrent urinary tract infections was randomized to r eceive postcoital prophylaxis with a dose of either 100 mg. ofloxacin (12), 200 mg. norfloxacin (11) or 125 mg. ciprofloxacin (10). While 13 0 urinary tract infections occurred in these patients during a mean of 8 months before postcoital quinolone prophylaxis, only 1 occurred dur ing a mean of 15 months following prophylaxis. This difference was sta tistically highly significant. Each of these patients ingested a mean of 117 quinolone doses per year of postcoital prophylaxis. Before prop hylaxis 74% of the introital cultures yielded gramnegative enterobacte ria (mainly Escherichia coli), whereas only 11% yielded the same bacte ria following prophylaxis. Postcoital oral prophylaxis with minimal qu inolone doses is highly effective in the prevention of recurrent urina ry tract infections in women, because it achieves high urinary bacteri cidal concentrations, and clears the majority of the introital and ure thral Enterobacteriaceae without inducing resistance to the quinolones despite long-term treatment. This prophylaxis is highly recommended b ecause of its ease of compliance, preservation of drug efficacy, lack of toxicity and cost-effectiveness. Postcoital quinolone prophylaxis i s as good as or better than daily quinolone prophylaxis and uses only a third of the amount of drug consumed in daily prophylaxis.