How Long Should Men's Urinary Infections Be Treated?

Extended course of antibiotics doesn't reduce repeat infections, study finds

By Robert Preidt

Wednesday, December 5, 2012

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WEDNESDAY, Dec. 5 (HealthDay News) -- Extending antibiotic treatment for urinary tract infections in men won't lower the odds that the infection will return, compared with a shorter period of treatment, a new study finds.
The best length of outpatient antibiotic treatment for women with urinary tract infection is known, but the optimum length for treatment in men is unclear. Length of antibiotic treatment is important, because therapy that's too short can lead to recurrent infection, while treatment that's too long can increase costs, promote antibiotic resistance and increase the risk of Clostridium difficile infection, the researchers noted.
C. difficile, which can cause diarrhea or serious inflammation of the colon, typically occurs after taking antibiotics.
This U.S. Veteran Affairs study included more than 33,000 men with an average age of 68 who received outpatient treatment for urinary tract infection.
Men who received longer antibiotic treatment -- more than seven days -- were no less likely to have early or late urinary tract infection recurrence than those who received antibiotic treatment for seven days or less, according to the study, which was published online Dec. 3 in the journal Archives of Internal Medicine.
Men who received extended treatment, however, were more likely to have late recurrence than those who received shorter treatment (about 11 percent vs. 8 percent), and were more likely to develop C. difficile infection (0.5 percent vs. 0.3 percent).
The findings "question the role" of longer duration outpatient antibiotic treatment for men with urinary tract infections, the researchers from the Minneapolis Veterans Affairs Health Care System said in a journal news release.
One expert said this type of data is key to guiding treatment.
"This well-designed study ... demonstrates that in men with a history of urinary tract infections, prolonged antibiotic use may not be needed," said Dr. Aaron Katz, chairman of urology at Winthrop University Hospital in Mineola, N.Y. "I have often found this to be the case in my own practice here at [the hospital] and I often tell patients that less is more."

SOURCE: Aaron Katz, M.D., chairman, urology, Winthrop University Hospital, Mineola, N.Y.; Archives of Internal Medicine, news release, Dec. 3, 2012

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