Efficacy of Trimethoprim-Sulfamethoxazole in Bacteriuria

Abstract

Sixty-three patients with bacteriuria were treated in a randomized double-blind study with the combination of trimethoprim and sulfamethoxazole (TMP-SMZ) or SMZ alone. Twenty-one of 32 patients treated with TMP-SMZ were cured by the time of followup compared with 14 of 31 treated with SMZ alone. Of the 26 patients infected with sulfonamide-resistant organisms, the combination cured 11 of 15, whereas SMZ alone cured three of 11. Thirty-five females had upper urinary tract infection. TMP-SMZ cured 12 of 18, and SMZ alone cured six of 17. An additional 48 patients with 50 episodes of infection were treated with the combination in an open-label study. Seventeen of 27 patients with upper tract infection were cured after two weeks of therapy. Therapy for seven days cured 12 of 14 episodes of asymptomatic or lower tract infection. Ten patients experienced side effects with the combination drug. There was no hematologic toxicity. In both studies, TMP-SMZ effectively eradicated sulfonamide-resistant pathogens, and a two week course of treatment cured two-thirds of females with upper tract infection.