Based on the rationale that (1) cystitis is a superficial mucosal infection pathologically, (2) successful treatment of bladder infections depends on antibiotic levels achieved in urine, and (3) many antibiotics achieve very high urinary concentrations, the concept of treating acute cystitis with a single-dose antibiotic regimen has been attractive to physicians for years. The observation that a single irrigation of the bladder with neomycin sulfate cures many patients with bladder bacteriuria further suggested that brief drug therapy might well be effective. Unfortunately, early attempts to use single-dose sulfonamides, streptomycin sulfate, and cephaloridine were not uniformly successful. Inclusion of patients with chronic infections, unrecognized upper-tract involvement (localization studies were not usually done), and drug-resistant organisms may have contributed to single-dose treatment failures. However, in 1967 Grüneberg and Brumfitt1 cured 88% of infections judged clinically to be cystitis with a single, 2-g dose of sulfadoxine (sulphormethoxine). Subsequently, Ronald et al,2
Stamm WE. Single-Dose Treatment of Cystitis. JAMA. 1980;244(6):591–592. doi:10.1001/jama.1980.03310060047025
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