[Uncomplicated lower urinary tract infection in women: new therapeutics]

Some twenty years ago, its was generally agreed that bacterial cystitis should be treated for 7 to 10 days, but since that time numerous clinical studies have suggested that shorter, single-dose or three-day treatments were possible. The single-dose chemotherapy of bacterial cystitis in women is a new and different approach with several prerequisites: strict clinical indication; use of a microbiologically and pharmacokinetically appropriate agent whose effectiveness has been demonstrated by clinical trials; close clinical and microbiological follow-up after treatment. Amoxicillin, aminoglycosides and above all drugs with prolonged urinary excretion, such as trimethoprim-sulfamethoxazole and notably fluoroquinolones (including pefloxacine), have proved to be effective as single-dose treatment of bacterial cystitis in women. In patients whose cystitis relapses at very short intervals, continuous or intermittent low-dose antibacterial prophylaxis may be contemplated, using trimethoprim-sulfamethoxazole, nitrofurantoin, trimethoprim alone or a quinolone. American authors have suggested, in some special cases, a patient-administered single-dose therapy at home as soon as the first signs of relapse appear.