Single-day treatment with trimethoprim for asymptomatic bacteriuria in the elderly patient

Recent reports have demonstrated an association between bacteriuria and excess mortality. Therefore, 40 inpatients 60 or more years old with asymptomatic bacteriuria participated in a double-blind trial to assess the effect of 1-day treatment with trimethoprim. The patients were allocated randomly to receive 100 mg. trimethoprim (20 patients) or placebo (20 patients) to be taken in the morning and evening for 1 day. All patients treated with trimethoprim obtained sterile urine, whereas all patients treated with placebo remained bacteriuric (p less than 0.002). No side effects were recorded. However, many of the cured patients suffered rapid reinfection. Of the 20 initially cured patients 14 (70 per cent, 95 per cent confidence limits 46 to 88 per cent) had recurrent bacteriuria after 6 weeks, indicating that although this treatment is effective immediately it imparts no long-term effect.