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June 19, 1981

Single-Dose Amoxicillin Therapy for Urinary Tract Infection

Author Affiliations

Kaiser-Permanente Medical Center Oakland, Calif

JAMA. 1981;245(23):2394-2395. doi:10.1001/jama.1981.03310480014013

To the Editor.—  Regarding the recent article by Rubin and associates (1980;244:561), "Single-Dose Amoxicillin Therapy for Urinary Tract Infection: Multicenter Trial Using Antibody-Coated Bacteria Localization Technique," I agree fully with these authors on the effectiveness of single-dose therapy for uncomplicated urinary tract infection (UTI).I wonder, however, if the article does not overemphasize the positive fluorescent antibody (FAB) test results. First, the chance of a false-positive test with a lower UTI may be frequent.1 Second, in my experience, even in patients with asymptomatic bacteriuria, the test result may change from positive to negative over a couple of weeks and back again, even though the same organism is grown in the urine. I would agree with Whitworth and Fairley2 that "recurrent urinary-tract infection may not always involve the same site even in a single episode of infection, and we consider the clinical value of such tests in an