Short-course treatment of urinary tract infection

Short-course treatment of simple cystitis is as effective as conventional 7-14 day therapy. It is less likely to cause adverse reactions or to generate bacterial resistance and is economical. Those patients who fail to respond may need further urological investigation. In short-course treatment the patient may be given a conventional dosage regimen over three days; a single conventional dose nightly for three nights; or just one massive dose. These approaches are discussed with reference to the pharmacological properties of agents available for oral administration. Clinical evidence suggests that, if the single-dose option is chosen, slowly excreted agents like trimethoprim or fosfomycin are preferable to beta-lactam agents or nitrofurantoin, which are rapidly excreted.