Trimethoprim-sulfamethoxazole vs sulfamethoxazole for acute urinary tract infections in children
J. B. Howard and Sr. Howard JE
A total of 118 children between 6 months and 10 years of age with acute
urinary tract infection were treated in a random; double-blind manner with
12 mg/kg/day of trimethoprim-sulfamethoxazole (61 patients) or 50 mg/kg/day
of sulfamethoxazole (57 patients) for ten days. Mean trimethoprim and
sulfamethoxazole susceptibilities of Escherichia coli isolated from these
patients were 1.2 and 0.6 microgram/ml, respectively. Mean serum
concentrations of trimethoprim and sulfamethoxazole were 1.8 and 62
microgram/ml, respectively, one hour after the dose. Of the children who
completed the ten days of prescribed medication, clinical and
bacteriological cure was confirmed immediately after treatment for all but
one patient in each group. Most patients in each treatment group with
recurrent infections had underlying urological abnormalities. Severe
hematological, renal, or hepatic toxicity requiring interruption of
treatment was not encountered. No advantage of
trimethoprim-sulfamethoxazole over sulfamethoxazole alone for acute urinary
tract infection was demonstrated.
