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Journal of Antimicrobial Chemotherapy (1985) 16, 509-517
© 1985 The British Society for Antimicrobial Chemotherapy

research-article

Comparison of long-term, low-dose pivmecillinam and nitrofurantoin in the control of recurrent urinary tract infection in children

An open, randomized, cross-over study

Niels L. T. Carlsen, Ulla Hesselbjerg and Paul Glenting

Department of Paediatrics, Randers Hospital Randers, Denmark

accepted 7 May 1985

Reprint requests: Niels L. T. Carlsen, Randers Centralsygehus, Paediatric Department, Østervangsvej 25, DK-8900 Randers, Denmark

Thirty-five children with a history of vesicoureteric reflux or with recurrent urinary tract infections were randomly allocated to low-dose prophylactic treatment with pivmecillinam or nitrofurantoin. After 6–10 months they were crossed over to the alternate drug for another 6 months, but only 24 completed the study because of lack of compliance or intolerance to nitrofurantoin. There was no significant difference in the long-term prophylactic effect between the two drugs, the overall infection rate being 0·7/patient-year. Pivmecillinam was significantly better tolerated than nitro furantoin (P = 0·01). Nitrofurantoin effected no major change in the faecal flora, and nearly all urinary infections occurring during long-term treatment were caused by Escherichia coli. In contrast, a marked reduction of E. coli and a marked increase in Gram-positive cocci were found in the faecal flora during treatment with pivmecillinam. Seventy per cent of infections were caused by Streptococcus faecalis and only 20% by E. coli during pivmecillinam treatment (P = 0·001).


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This article has been cited by other articles:


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