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Three-day therapy of lower urinary tract infections with nitrofurantoin macrocrystals: a randomized clinical trial
Insights
A three-day course of nitrofurantoin macrocrystals effectively treats symptomatic urinary tract infections in girls. This shorter regimen showed comparable relapse and reinfection rates to a ten-day treatment, offering a potentially more convenient option.
Area of Science:
- Pediatric infectious diseases
- Pharmacology and therapeutics
Background:
- Urinary tract infections (UTIs) are common in young girls.
- Optimal antibiotic duration for uncomplicated lower UTIs in pediatric populations requires further investigation.
Purpose of the Study:
- To compare the efficacy of a three-day versus a ten-day course of nitrofurantoin macrocrystals for treating symptomatic lower UTIs in girls aged 2–18 years.
Main Methods:
- A double-blind study involving 49 girls with documented UTIs.
- Patients received either three or ten days of nitrofurantoin macrocrystals.
- Urine cultures were assessed for sterility during therapy and follow-up for relapse and reinfection over six months.
Main Results:
- All patients achieved sterile urine by day three.
- Relapse rates were 8.7% (ten-day group) and 7.7% (three-day group).
- Reinfection rates were 30% (ten-day group) and 23% (three-day group), with no statistically significant differences between groups.
Conclusions:
- A three-day course of nitrofurantoin macrocrystals is as effective as a ten-day course for uncomplicated lower UTIs in girls.
- Shorter treatment durations may be a viable option, potentially improving adherence and reducing side effects.
Abstract:
Forty-nine girls between the ages of 2 and 18 years with a symptomatic urinary tract infection documented by two clean-catch urine cultures completed a double-blind study comparing the effectiveness of three days versus ten days of nitrofurantoin macrocrystal therapy. Localization of the infection to the lower urinary tract was presumed on the basis of clinical presentation. All patients had sterile urine on day two or three of therapy. In the ten-day group, two of 23 patients (8.7%) experienced a single relapse, and seven patients (30%) had 12 episodes of reinfection during a six-month follow-up. In the three-day group, two of 26 patients (7.7%) had a single relapse, and six patients (23%) had 12 episodes of reinfection. The rates of relapse and reinfection in the compared groups were not statistically significantly different (P greater than 0.05). Three days of treatment with nitrofurantoin macrocrystals is an effective regimen for symptomatic girls presumed to have uncomplicated lower urinary tract infections.