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1 day of nitrofurantoin was not as effective as 7 days for asymptomatic bacteriuria in pregnancy
Evidence-Based Medicine, 08/10/09
Vousden N et al. – In pregnant women with asymptomatic bacteriuria, a 1–day regimen of nitrofurantoin was not as effective as a 7–day regimen.
Methods- Randomised controlled trial.
- Patients: 778 pregnant women (mean age 27 y) at 12–32 weeks of gestation who were diagnosed (by a 2–step screening process) as having asymptomatic bacteriuria caused by a micro–organism sensitive to nitrofurantoin. Women with symptoms of urinary tract infection (UTI), treatment of UTI in the current pregnancy, a condition requiring continuous steroid or antibiotic therapy, antibiotic hypersensitivity, or haematological disease (including glucose–6–phosphate dehydrogenase deficiency) were excluded.
- Nitrofurantoin, 100 mg orally twice daily, for 1 day (n = 386) or 7 days (n = 392). The 1–day group received placebo tablets after day 1 to maintain blinding.
- Bacteriological cure rate was lower with the 1–day regimen than with the 7–day regimen.
- Mean gestational age at delivery and mean birth weight were lower in the 1–day group.
- Groups did not differ for symptomatic UTI; adverse effects such as nausea, headache, and flatulence; preterm birth or low birth weight; or congenital malformations.
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