June 19, 1981

Single-Dose Amoxicillin Therapy for Urinary Tract Infection-Reply

Author Affiliations

Massachusetts General Hospital Harvard Medical School Boston
University of Oregon Health Sciences Center Portland
University of Texas Southwestern Medical Center Dallas

JAMA. 1981;245(23):2395. doi:10.1001/jama.1981.03310480014014

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In Reply.—  We appreciate Dr Rubinoff's comments and would agree with the thrust of his argument—that is, single-dose therapy can and should be given to reliable women with acute, uncomplicated UTI without having to resort to the antibody-coated bacteria (ACB) assay. Our using the ACB assay for research purposes does not constitute a requirement that it be used in everyday clinical practice. To put the ACB test and single-dose therapy in perspective, we would make the following comments:

  1. Single-dose therapy is effective in 85% to 95% of women with ACB-negative infection, with most of these failures occurring in women with first infections for which the ACB test is unreliable.

  2. Single-dose therapy is effective in 40% to 50% of patients with ACB-positive infection (R. H. Rubin, MD, unpublished data, October to December, 1980), confirming Dr Rubinoff's observation. Thus, the ACB-positive population is nonhomogeneous, and the response to single-dose