A Clinical Comparison Between Macrodantin and Trimethoprim for Prophylaxis in Women With Recurrent Urinary Infections

J Antimicrob Chemother. 1985 Jul;16(1):111-20. doi: 10.1093/jac/16.1.111.


Seventy-two patients with a history of at least three attacks of urinary infection in the previous 12 months were assigned randomly to long-term prophylaxis with 100 mg at night of either Macrodantin (34 patients) or trimethoprim (38 patients). The mean interval between symptomatic attacks while on either treatment was increased three-fold compared with the pretreatment period. Macrodantin was significantly more effective (P less than 0.05) at preventing bacteriuria. Prophylaxis was equally effective in patients with and without a radiological abnormality. Side effects were significantly more common (P less than 0.05) in the group taking Macrodantin. In patients taking trimethoprim acquisition of resistance by faecal coliforms occurred at a rate of about 5%/month, and breakthrough infections were almost exclusively caused by trimethoprim-resistant coliforms. No acquisition of resistance occurred in patients taking Macrodantin, and the few breakthrough infections noted were due to sensitive bacteria.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Feces / microbiology
  • Female
  • Humans
  • Nitrofurantoin / adverse effects
  • Nitrofurantoin / therapeutic use*
  • Trimethoprim / adverse effects
  • Trimethoprim / therapeutic use*
  • Urinary Tract Infections / drug therapy*
  • Urinary Tract Infections / prevention & control


  • Nitrofurantoin
  • Trimethoprim