A total of 33 sexually active, premenopausal and postmenopausal women, suffering from recurrent
urinary tract infections was randomized to receive postcoital prophylaxis with a dose of either 100 mg.
ofloxacin (12), 200 mg.
norfloxacin (11) or 125 mg.
ciprofloxacin (10). While 130
urinary tract infections occurred in these patients during a mean of 8 months before postcoital
quinolone prophylaxis, only 1 occurred during a mean of 15 months following prophylaxis. This difference was statistically highly significant. Each of these patients ingested a mean of 117
quinolone doses per year of postcoital prophylaxis. Before prophylaxis 74% of the introital cultures yielded gram-negative enterobacteria (mainly Escherichia coli), whereas only 11% yielded the same bacteria following prophylaxis. Postcoital oral prophylaxis with minimal
quinolone doses is highly effective in the prevention of recurrent
urinary tract infections in women, because it achieves high urinary bactericidal concentrations, and clears the majority of the introital and urethral Enterobacteriaceae without inducing resistance to the
quinolones despite long-term treatment. This prophylaxis is highly recommended because of its ease of compliance, preservation of
drug efficacy, lack of toxicity and cost-effectiveness. Postcoital
quinolone prophylaxis is as good as or better than daily
quinolone prophylaxis and uses only a third of the amount of
drug consumed in daily prophylaxis.