Urinary Tract Infections With Low and High Colony Counts in Young Women: Spontaneous Remission and Single-Dose vs Multiple-Day Treatment-Reply

I thank Pfau for his interest in our article.¹ Overall, my impression is that single-dose treatment of urinary tract infection is less effective than multiple-day treatment.^2,3 Some agents are probably more effective than others when used as a single-dose treatment,³ and conceivably one of the quinolones given in a single dose may have efficacy comparable to that of multiple-day treatment. I am afraid that the study by Pfau et al⁴ does not offer convincing evidence in favor of the use of ofloxacin or ciprofloxacin as a single-dose treatment. The rates of cure, as given in the article and in the letter, are based on 11 patients who remained infected after treatment, but they do not include the nine patients with reinfection. Furthermore, the mean duration of follow-up was only 9.7 days. Stronger evidence has to be brought to convince us that an antibiotic drug can be