Uncomplicated urinary tract infections — is single-dose therapy effective?

Abstract

Short-term therapy, including single-dose treatment and up to 3-day courses, can be considered the treatment of choice in female patients with acute uncomplicated lower urinary tract infections (UUTI) because of equal effectiveness, better tolerance and compliance, and lower cost as compared with conventional therapy. Retrospective analysis of several studies with cotrimoxazole, however, suggested that results obtained with a single dose may be inferior, and therefore a 3-day treatment may be more prudent. Longer therapy was not considered to be necessary. On the other hand, studies with substances like fosfomycin trometamol and some of the fluotoquinolones, especially when using substances with prolonged half-lives such as fleroxacin and pefloxacin, have demonstrated that single-dose therapy is as effective as other standard regimens. This controversy may be settled by defining the appropriate agents for single-dose as well as those for 3-day treatment. Agents which have not been shown to be effective in any of these short-term regimens should no longer be propagated for the treatment of UUTI. In consequence, no further studies using conventional therapy of UUTI are necessary in the future.