Skip to main content
Antimicrobial Agents and Chemotherapy logoLink to Antimicrobial Agents and Chemotherapy
. 1989 Jul;33(7):1032–1035. doi: 10.1128/aac.33.7.1032

Prospective, randomized, placebo-controlled trial of norfloxacin for the prophylaxis of recurrent urinary tract infection in women.

L E Nicolle 1, G K Harding 1, M Thompson 1, J Kennedy 1, B Urias 1, A R Ronald 1
PMCID: PMC176057  PMID: 2675752

Abstract

Thirty women were randomized in a double-blind, placebo-controlled study to receive either norfloxacin, 200 mg orally daily at bedtime, or placebo for the prevention of recurrent bladder infection. Subjects were followed monthly to monitor compliance and symptoms, for urine culture and periurethral and anal canal swabs to monitor colonization, and for blood specimens for hematologic and biochemical studies to monitor safety. During 1 year of follow-up, 10 of 15 placebo subjects and none of 15 norfloxacin subjects developed infection (P less than 0.001). Adverse effects occurred with equal frequencies in the two groups. For norfloxacin subjects, only 2 (1.6%) of 129 periurethral and 4 (3.1%) of 129 anal canal swabs showed colonization with aerobic gram-negative organisms, while 16 (22%) of 73 periurethral and 47 (64%) of 73 anal canal swabs from placebo subjects showed colonization. Daily therapy with norfloxacin at bedtime is effective in preventing recurrent cystitis. During 1 year of norfloxacin therapy, colonization was infrequent and superinfection with norfloxacin-resistant organisms did not occur.

Full text

PDF
1032

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bailey R. R., Roberts A. P., Gower P. E., De Wardener H. E. Prevention of urinary-tract infection with low-dose nitrofurantoin. Lancet. 1971 Nov 20;2(7734):1112–1114. doi: 10.1016/s0140-6736(71)91270-0. [DOI] [PubMed] [Google Scholar]
  2. Boerema J. B., Olthof B. J., van Saene H. K. Effects of norfloxacin on the faecal flora in patients with complicated urinary tract infections. Scand J Infect Dis Suppl. 1986;48:27–31. [PubMed] [Google Scholar]
  3. Bow E. J., Rayner E., Louie T. J. Comparison of norfloxacin with cotrimoxazole for infection prophylaxis in acute leukemia. The trade-off for reduced gram-negative sepsis. Am J Med. 1988 May;84(5):847–854. doi: 10.1016/0002-9343(88)90062-9. [DOI] [PubMed] [Google Scholar]
  4. Haase D. A., Harding G. K., Thomson M. J., Kennedy J. K., Urias B. A., Ronald A. R. Comparative trial of norfloxacin and trimethoprim-sulfamethoxazole in the treatment of women with localized, acute, symptomatic urinary tract infections and antimicrobial effect on periurethral and fecal microflora. Antimicrob Agents Chemother. 1984 Oct;26(4):481–484. doi: 10.1128/aac.26.4.481. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Harding G. K., Buckwold F. J., Marrie T. J., Thompson L., Light R. B., Ronald A. R. Prophylaxis of recurrent urinary tract infection in female patients. Efficacy of low-dose, thrice-weekly therapy with trimethoprim-sulfamethoxazole. JAMA. 1979 Nov 2;242(18):1975–1977. [PubMed] [Google Scholar]
  6. Harding G. K., Ronald A. R. A controlled study of antimicrobial prophylaxis of recurrent urinary infection in women. N Engl J Med. 1974 Sep 19;291(12):597–601. doi: 10.1056/NEJM197409192911203. [DOI] [PubMed] [Google Scholar]
  7. Nicolle L. E., Harding G. K., Thomson M., Kennedy J., Urias B., Ronald A. R. Efficacy of five years of continuous, low-dose trimethoprim-sulfamethoxazole prophylaxis for urinary tract infection. J Infect Dis. 1988 Jun;157(6):1239–1242. doi: 10.1093/infdis/157.6.1239. [DOI] [PubMed] [Google Scholar]
  8. Nicolle L. E., Ronald A. R. Recurrent urinary tract infection in adult women: diagnosis and treatment. Infect Dis Clin North Am. 1987 Dec;1(4):793–806. [PubMed] [Google Scholar]
  9. Sanford J. P. Urinary tract symptoms and infections. Annu Rev Med. 1975;26:485–498. doi: 10.1146/annurev.me.26.020175.002413. [DOI] [PubMed] [Google Scholar]
  10. Stamey T. A., Condy M., Mihara G. Prophylactic efficacy of nitrofurantoin macrocrystals and trimethoprim-sulfamethoxazole in urinary infections. Biologic effects on the vaginal and rectal flora. N Engl J Med. 1977 Apr 7;296(14):780–783. doi: 10.1056/NEJM197704072961403. [DOI] [PubMed] [Google Scholar]
  11. Stamm W. E., Counts G. W., Running K. R., Fihn S., Turck M., Holmes K. K. Diagnosis of coliform infection in acutely dysuric women. N Engl J Med. 1982 Aug 19;307(8):463–468. doi: 10.1056/NEJM198208193070802. [DOI] [PubMed] [Google Scholar]
  12. Stamm W. E., Counts G. W., Wagner K. F., Martin D., Gregory D., McKevitt M., Turck M., Holmes K. K. Antimicrobial prophylaxis of recurrent urinary tract infections: a double-blind, placebo-controlled trial. Ann Intern Med. 1980 Jun;92(6):770–775. doi: 10.7326/0003-4819-92-6-770. [DOI] [PubMed] [Google Scholar]

Articles from Antimicrobial Agents and Chemotherapy are provided here courtesy of American Society for Microbiology (ASM)

RESOURCES