From the FDA Drug Label
The recommended dosage for prophylaxis in adults is 4 teaspoonfuls (20 mL) of sulfamethoprim and trimethoprim oral suspension daily. Children: For children, the recommended dose is 750 mg/m 2/day sulfamethoxazole with 150 mg/m 2/day trimethoprim given orally in equally divided doses twice a day, on 3 consecutive days per week
The recommended dose of suppressive antibiotics is 4 teaspoonfuls (20 mL) daily for adults and 750 mg/m 2/day sulfamethoxazole with 150 mg/m 2/day trimethoprim, given orally in equally divided doses twice a day, on 3 consecutive days per week for children 1.
From the Research
The recommended dose for suppressive antibiotics is a low-dose, long-term regimen, typically consisting of nitrofurantoin 50-100 mg once daily, as this approach has been shown to be effective in preventing recurrent urinary tract infections while minimizing the risk of antibiotic resistance 2.
Key Considerations
- The choice of antibiotic should be based on the patient's specific needs and medical history, as well as local resistance patterns.
- The duration of suppressive therapy is typically 3-6 months, after which a trial off antibiotics can be considered to assess if recurrent infections have resolved.
- Patients should be monitored for side effects and antibiotic resistance with periodic urine cultures every 3 months.
- Suppressive antibiotics work by maintaining a constant low level of antimicrobial activity in the urinary tract, preventing bacterial colonization and subsequent infection.
Supporting Evidence
- A study published in 2020 found that implementation of a urinary tract infection treatment protocol improved prescribing practices in a long-term care facility, with a significant increase in the use of nitrofurantoin and cefpodoxime/ceftriaxone as empiric therapy 2.
- Another study published in 2020 discussed the treatment of urinary tract infections in the era of antimicrobial resistance and new antimicrobial agents, highlighting the importance of choosing the right antibiotic based on local resistance patterns and patient-specific factors 3.
- A review published in 2014 discussed the diagnosis and management of urinary tract infections in the outpatient setting, emphasizing the importance of individualized assessment of risk factors for resistance and regimen tolerability 4.