RAZ R, COLODNER R, STAMM W; Interscience Conference on Antimicrobial Agents and Chemotherapy (42nd : 2002 : San Diego, Calif.).

Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 2002 Sep 27-30; 42: abstract no. L-1798.

Infectious Diseases Unit, Ha'Emek Medical Center, Afula, Israel.

BACKGROUND: Long-term antimicrobial prophylaxis, especially Nitrofurantoin Macrocrystals(NFM), is effective in preventing bacteriuria in elderly women. Several studies have also shown that intravaginal estriol reduces new episodes of bacteriuria. We compared efficacy and safety of intravaginal estriol vs. oral NFM. in preventing recurrent UTI in postmenopausal women. METHODS: Postmenopausal women with recurrent UTI were enrolled in this randomized double-blind double dummy study. One group received a vaginal pessary containing 0.5mg estriol twice a week with daily oral placebo and the second group received oral NFM. daily and a placebo vaginal pessary twice weekly, both for 9 months. Clinical follow-up and urinary cultures were conducted monthly and gynecological follow-up prior to and at 1,3 and 9 months of study. Primary efficacy parameter (P.E.M) was absence of bacteriuria and secondary (S.E.P) included effects of study drugs on vaginal cytology, pH and flora, and accceptance of drugs. RESULTS: From 6/1996 to 1/1999, 150 women were included by ITT analysis; 79 received estriol and 71 NFM. The P.E.P showed 123 UTI episodes (symptomatic & asymptomatic) in estriol group vs. 42 in NFM. (p<0.0003). Only 28 (35%) of estriol women were free of bacteriuria during the 9 months and 41 (58%) of NFM. patients (p=0.01). While estriol women had 1.9 episodes of UTI/woman/year, NFM. group had 0.8 episodes/woman/year. Regarding S.E.P, we found a significant increase in superficial cells in estriol group but no proliferation of lactobacilli or reduction of vaginal pH. Percentage of adverse events was similar in both groups. Conclusion: Estriol pessary was considerably less effective than NFM. in preventing bacteriuria, probably because of its failure to alter the absence of vaginal lactobacillus and reduce pH.

Publication Types:

• Meeting Abstracts

Keywords:

• Aged
• Bacteriuria
• Estriol
• Female
• Humans
• Lactobacillus
• Menopause
• Pessaries
• Urinary Tract Infections
• Urogenital System
• Vagina

Other ID:

• GWAIDS0027984

UI: 102267608

From Meeting Abstracts