Preanesthetic cimetidine and metoclopramide for acid aspiration prophylaxis in elective surgery

The effect of preanesthetic cimetidine and metoclopramide on gastric contents in inpatients undergoing elective surgery was studied. One hundred and fifty patients were allocated randomly into six groups with 25 patients in each group. Patients in Group 1 served as control. Group 2 patients received metoclopramide in the morning. Group 3 patients received cimetidine at bedtime and in the morning. Patients in Group 4 received cimetidine at bedtime and metoclopramide in the morning. Group 5 patients received cimetidine and metoclopramide in the morning, while patients in Group 6 received cimetidine at bedtime and metoclopramide and cimetidine in the morning. Cimetidine 300 mg and metoclopramide 10 mg were administered by mouth with a sip of water at bedtime or in the morning 1-4 h prior to the induction of anesthesia. Patients with gastric pH less than or equal to 25 or gastric content volume greater than or equal to 25 ml were defined to be at risk of pulmonary damage if aspiration should occur. In the control group the mean pH and volume of gastric contents were 2.89 and 22.3 ml, respectively, with 64% of patients with pH less than or equal to 2.5 and 32% of patients with volumes of greater than or equal to 25 ml. Cimetidine and metoclopramide favorably modified the risk factors in all the experimental groups. This study demonstrated that the three groups receiving cimetidine in the morning (Groups 3, 5, and 6) had significantly greater mean gastric pH than the other groups. Gastric volumes were significantly less in all experimental groups.(ABSTRACT TRUNCATED AT 250 WORDS)     

Circumcision for the prevention of significant bacteriuria in boys

The aim of this study was to determine whether circumcision affects significant bacteriuria in boys. During a 60-month prospective study, 100 boys with microbiologically confirmed symptomatic urinary tract infection (UTI) were evaluated. Twelve patients with abnormal ultrasonography findings were excluded from the study. Eighteen of the boys had not been circumcised due to parental choice. The remaining 70 boys with normal renal ultrasonography were randomly allocated into two groups. In the first group 35 boys ranging in age from 6 months to 10 years (mean 33.2±30.9 months) were observed for 6 months and urinary cultures were taken monthly. When they had a positive urine culture (with or without any symptoms), they received antibiotic treatment. After 6 months they were circumcised and then observed for another 6-month period. Group 2 comprised 35 boys aged from 3 months to 9 years (mean 29.1±36.7 months). They were circumcised immediately after the first UTI and were followed for 6 months. Urine samples were obtained by the bag technique in infants and by the mid-stream technique in older patients. In the uncircumcised group, the rate of significant bacteriuria per patient did not change in two 6-month follow-up periods (3.46±0.91 and 3.33±0.97 episodes). In group 1, the rate of positive urine cultures dropped from 3.57±1.11 to 0.14±0.35 episodes after circumcision (P<0.001). In the second group, the rate of significant bacteriuria was 0.17±0.38 episodes after circumcision. Among the uncircumcised patients, symptomatic UTI was observed in 6 cases (3 cases in the first period of group 1, 1 case in the first and 2 cases in the second period of the uncircumcised group), whereas after circumcision no patient had symptomatic UTI. The mean age at circumcision was 42.7±28.4 months. No complication due to circumcision occurred in any patient. UTI may also occur in boys after the 1st year of life. The present study indicated that circumcision in boys decreases the rate of positive urine cultures. Therefore circumcision could be considered as a part of UTI therapy. Received: 30 January 2001 / Revised: 25 June 2001 / Accepted: 26 June 2001     

Prulifloxacin vs fosfomycin for prophylaxis in female patients with recurrent UTIs: a non-inferiority trial

Introduction and hypothesis

This multicentre, randomised, non-blinded, parallel group study is designed to assess the null hypothesis that a 3-month prophylactic schedule with fosfomycin is not inferior to prulifloxacin in reducing the number of urinary tract infection episodes during and after prophylaxis in female patients with recurrent urinary tract infections (rUTIs).

Methods

One hundred and fifty-two patients with rUTIs who were candidates for prophylaxis therapy were enrolled and randomised to prulifloxacin (group 1) or fosfomycin (group 2). The prophylaxis regimen included a single dose of fosfomycin (one 3-g cachet) per week, or a single dose (600 mg) of prulifloxacin (one tablet) a week for 12 weeks. The inclusion criteria were female patients over 18 years, urine culture responsiveness to drugs at patient recruitment and history of rUTI. Exclusion criteria were pregnancy and counter-indications to this drug therapy. Patients were prospectively randomised. Check-ups were scheduled at 2 weeks, 1 month and 3 months from the beginning of the study and 3, 6, and 12 months after suspension of the therapy. The primary end-points were the reduction of the number of UTIs (negative urine culture) during and after prophylaxis.

Results

Final data analysis included 67 patients in group 1 and 57 in group 2. Nine out of 76 patients (group 1) and 19 out of 76 (group 2) dropped out. UTI episodes were significantly reduced in number compared with before prophylaxis (p? p?=?0.41), in the reduction of UTI episodes during and after prophylaxis, in the adverse effects or improved quality of life.

Conclusions

Both drugs provided adequate prophylaxis in patients with rUTIs, with no difference in efficacy.     

Recurrence and follow-up after urinary tract infection under the age of 1 year

In order to analyze the risk factors for recurrence and the value of routine follow-up by monthly urine cultures in a group of children who had their first episode of urinary tract infection (UTI) under 1 year of age, we performed a retrospective survey of 262 children (134 girls, 128 boys) who were treated for their first UTI while aged under 1 year in the Department of Pediatrics, University of Oulu, during the years 1978–1984. Detailed data on these children concerning their first and recurrent UTIs were collected from hospital records using a formulated data sheet. Causative bacteria and vesicoureteral reflux (VUR) were analyzed as possible risk factors for recurrent UTI. The time of recurrence and the possible symptoms during the recurrent UTI were also investigated. The follow-up period after the first UTI was 3 years; 35% of the boys and 32% of the girls contracted a recurrent UTI during the 3-year follow-up. In 86% of cases, the first UTI recurrence occurred within 6 months of the primary UTI. Recurrent UTIs were detected significantly earlier with routine monthly follow-up compared with those seeking treatment because of symptoms (log rank test P<0.01). There was a significant difference in the number of recurrences of UTI according to the grade of VUR (P=0.006). Recurrence-free survival was shorter and recurrent UTIs occurred more often in the children with grade 3–5 VUR than in those with grade 0–2 VUR (log rank test P=0.0005). Children without VUR and children with grade 1–2 VUR did not differ in the recurrence rate, and thus grade 1–2 VUR did not increase the risk for recurrent UTI. Monthly routine urine cultures are efficient in detecting recurrent UTI infections in children. Since grade 3–5 VUR is a risk factor both for increased recurrence rate of UTI and for possible subsequent renal damage, these children should be followed with monthly urine cultures for UTI recurrences if not on preventive medication. Since the vast majority of UTI recurrences occur within 6 months of the first UTI, routine follow-up for 6 months seems to be sufficient after symptomatic UTI in children with grade 3–5 VUR. Received: 10 January 2000 / Revised: 21 August 2000 / Accepted: 21 August 2000     

Antibiotic prophylaxis by low-dose cefaclor in children with vesicoureteral reflux

Sulfamethoxazole/trimethoprim (SMX/TMP) and nitrofurantoin are the most frequently used agents for prophylaxis to reduce the risk of recurrent urinary tract infections (UTIs) in children with vesicoureteral reflux (VUR). Nitrofurantoin, however, is not available in Japan and increasing resistance of organisms to SMX/TMP has recently raised doubts about its effectiveness as a prophylactic agent. This study was conducted to investigate whether antibiotic prophylaxis using low-dose cefaclor can effectively reduce the risk of recurrent UTIs. Thirty-nine children (31 male, 8 female) with primary VUR were enrolled. Ages varied from 0.5 to 111 months (mean 10.6 months). A prophylactic dose of 5-10 mg cefaclor per kg per day was given 1-3 times daily depending on the patient's age. Mean duration of prophylactic treatment was 15.5 months. Eleven children (ten male, one female) developed breakthrough UTIs during a total of 606 months treatment (or about one further infection in 55 months). Resistance to cefaclor was noted in three organisms: Enterococcus spp., Morganella spp., and Pseudomonas spp. Evidence of antibacterial activity was present in the morning urine samples from all of seven children tested. Cefaclor was well accepted and tolerated by all subjects. None withdrew from the study because of side effects. These results suggest that cefaclor can be an alternative choice for prophylactic treatment because of its safety, good compliance and low rates of resistant Escherichia coli.     

Treatment of complicated urinary tract infections by ofloxacin

To study the treatment effects of ofloxacin (OFLX) on the patients with complicated urinary tract infections (UTI), OFLX at a daily dose of 600 mg divided into either two or three doses per day, was administered for 14 days to 114 patients with complicated UTI. Among the 114 patients, 67 patients satisfied the criteria for clinical evaluation of complicated UTI. One hundred and one organisms were isolated from these patients' urine. Among them, 82 organisms were eliminated following OFLX administration. Twenty organisms appeared newly by the replacement of organisms. Among them, 6 organisms belonged to Candida sp. As to the overall efficacy of OFLX, an excellent response was seen in 37.3% and sum of efficacy rate was 65.7%. Side effects were observed in 3 of the 114 patients. These results indicate that OFLX is both safe and effective enough to be used for the treatment of the patients associated with complicated UTI.     

Efficacy of antibiotic prophylaxis in patients undergoing cystoscopy: a randomized clinical trial

Objective

To establish the efficacy of antibiotic prophylaxis prior to cystoscopy in outpatients in decreasing the incidence of post-procedure urinary tract infection.

Study design and setting

A randomized clinical trial in patients (men and women) older than 18 who underwent cystoscopy for any non-urgent indication. The intervention was Levofloxacin 500 mg single dose, and the control was placebo 500 mg single dose made with similar characteristics. The primary outcome was urinary tract infection (UTI) measured 3–10 days after the procedure. It was performed as per protocol analysis.

Results

Hundred and thirty-eight patients in each study arm completed the trial. The incidence of UTI in the intervention group was 0.7 % and in the placebo group was 3 % (p = 0.17), and no significant differences were found. The incidence of asymptomatic bacteriuria in the intervention group was 5.8 % and in the control group was 14.5 % (p = 0.01).

Conclusions

No significant differences were found in the use of prophylactic antibiotic compared to placebo to reduce the incidence of UTI in patients who undergo cystoscopy as an outpatient procedure with sterile urine demonstrated by urine culture.     

Primary urinary tract infection in infants: prophylaxis for uncomplicated pyelonephritis

BACKGROUND: Urinary tract infection (UTI) is one of the most common causes of unexplained fever in infants with a reported prevalence range of 5-11%. The clinical and laboratory findings were reviewed, and diagnosis and treatment for 95 infants with primary UTI were evaluated in this study. METHODS: All patients underwent renal ultrasonography, voiding cystourethrogram and 99mTc dimercaptosuccinic acid (DMSA) scan during hospitalization before treatment, with treatment consisting of 2- or 4-week appropriated antibiotic therapy for the patients associated upper UTI, followed by a second DMSA scan 6 months after therapy. RESULTS: In the present study the main symptom of UTI in infants was fever. High white blood cell count was not necessarily present, and urinalysis was also an imperfect diagnostic tool for discriminating UTI. In addition, colony count from urine culture and kidney ultrasonography was not efficacious in terms of predicting the occurrence of pyelonephritis. Intravenous antibiotic for 1 week followed by 3 weeks of the same oral antibiotic provided good prophylaxis for uncomplicated pyelonephritis. CONCLUSION: Four weeks of antibiotic treatment resulted in good recovery from pyelonephritis in the present sample of infant primary UTI cases. voiding cystourethrogram, DMSA and ultrasonography scanning should be performed in primary infant UTI.     

盐酸米托蒽醌膀胱灌注预防尿路上皮移行细胞癌复发

目的：评价盐酸米托蒽醌膀胱灌注预防尿路移行上皮细胞癌膀胱内复发的有效性、患者耐受性及其毒副作用。方法：对21例手术后经病理检查证实为尿路上皮移行细胞癌而且保留膀胱的患者，以盐酸米托蒽醌作膀胱灌注，记录膀胱灌注过程中的相关情况。结果：随访1～12个月，4例复发，1例恶化，复发率为19．0％(4／21)，1年未复发率76．2％(16／21)，平均无瘤间期10．3个月。9例发生局部并发症，复查血常规及肝、肾功能灌注前后差异无统计学意义。结论：初步随访证实，盐酸米托蒽醌降低尿路上皮移行细胞癌术后复发，大部分患者耐受良好，无明显全身毒副作用。     

Efficacy of high-dose trimethoprim-sulfamethoxazol prophylaxis on early urinary tract infection after renal transplantation

Urinary tract infection (UTI), a major cause of morbidity in renal transplant recipients, has also been found to increase mortality. The first month post-kidney transplantation is considered the critical time, with most UTI episodes during this period. The aim of this study was to compare the efficacy of various doses of trimethoprim-sulfamethoxazole (TMP/SXT) for the prophylaxis of the posttransplant UTI within the first month after kidney transplantation. In a prospective, double-blind, randomized, clinical trial, 95 kidney allograft recipients were divided into two groups: group 1 (n = 63) received low to moderate doses of TMP/SXT (either 80/400 mg or 160/800 mg, daily) and group 2 (n = 32), high doses of TMP/SXT (320/1600 mg, daily in two divided doses). These groups were comparable regarding age, gender, type of donor, and ureteral anastomosis and immunosuppressive therapy. UTI was defined as a urine culture containing more than 10(5) colonies. The mean age of the patients was 37 +/- 12.2 years with a male/female ratio of 0.98/1. The urine culture was positive in 39 patients (41.1%). UTI was more common among female than male patients (P = .003). Escherichia coli was the most common isolated organism in both groups (53.8%). UTI was observed in about 25% of patients on the high-dose versus 49.2% of those on low- to moderate-dose prophylaxis (P < .05). In conclusion, prophylaxis with high-dose TMP/SXT (320/1600 mg, daily) is preferred for renal transplant recipients during the first month posttransplantation.     

Effective postcoital prophylaxis of recurrent urinary tract infections in premenopausal women: A review

A total of 77 sexually active premenopausal women, susceptible to recurrent urinary tract infections (UTI) but otherwise healthy, were subjected to postcoital prophylaxis consisting of a single oral dose of either cotrimoxazole (80 mg trimethoprim+400 mg sulfamethoxazole), 50 mg nitrofurantoin macrocrystals, 500 mg nalidixic acid, 250 mg cinoxacin or 250 mg cephalexin. Postcoital prophylaxis reduced the incidence of recurrent UTI from 5-8 UTI per patient/year prior to prophylaxis, to a mere 0.03 UTI per patient/ year following prophylaxis. The differences in the incidence of UTI prior to and following institution of postcoital prophylaxis were statistically highly significant. A mean of 106–120 antibacterial tablets per patient were administered per year.Postcoital prophylaxis of recurrent UTI in premenopausal women is highly effective because of easy compliance, the high urinary concentration achieved and the minimal induction of resistance in the introital Gram-negative bacterial flora, irrespective of the length of time this prophylaxis is used. Furthermore, postcoital prophylaxis is significantly more effective than daily, as it achieves the same effect but requires only one third or fewer of the antibacterial tablets used in daily prophylaxis. At present, postcoital prophylaxis with cotrimoxazole, nitrofurantoin macrocrystals or cephalexin is recommended.     

Prophylactic co-trimoxazole and trimethoprim in the management of urinary tract infection in children

In a prospective study of low-dose antibacterial prophylaxis of childhood urinary tract infection (UTI), co-trimoxazole and trimethoprim (TMP) have been compared for efficacy in preventing UTI, for their effect on the rectal flora and for secular selection of TMP-resistant organisms.Between 1979 and 1986, 334 children who had proven infection of an unobstructed urinary tract complied in a regimen of low-dose prophylaxis together with measures to eliminate residual urine for at least 6 months. Of these children, 167 had vesico-ureteric reflux and 27 had renal scarring. There was no difference between the two drugs in compliance, which was very good, or in the occurrence of side-effects, which were minimal. Recurrence rates of further infection were 1 per 22 child years for the 226 children receiving cotrimoxazole and 1 per 18 child years for the 108 receiving TMP. All but one of these urinary pathogens were resistant to TMP and reinfection of the urinary tract generally occurred following lapses in attention to complete bladder emptying. Neither a secular increase in recurrent infections during this period, nor a significant change in the proportions of TMP-resistant faecal coliform organisms, was observed. TMP and co-trimoxazole appeared to be equally effective prophylactic agents.     

膀胱镜检前预防性应用抗生素的多中心临床研究

目的:探讨膀胱镜检查前预防性应用抗生素的临床价值。方法:采用多中心前瞻性临床研究的方法,选取2012年9月~2013年10月中段尿标本培养阴性的患者357例,随机分为两组。A组177例,为预防性应用抗生素组,检查前30~60分钟口服左氧氟沙星500mg;B组180例,为对照组,检查前30~60分钟口服安慰剂。比较膀胱镜检查后两组患者尿路感染的发生率。结果:A组患者尿路感染发生率为1.1%;B组患者尿路感染发生率为3.9%,两组比较差异无统计学意义(P=0.096)。结论:无高危因素存在时,预防性应用抗生素并不能降低膀胱镜检查后尿路感染的发生率。     

Intravesical Bacillus Calmette-Guérin prophylactic treatment for superficial bladder tumors: results of a controlled prospective study

A controlled prospective study in 100 patients evaluated the efficacy of intravesical bacillus Calmette-Guérin (BCG) administration as prophylactic treatment on tumor recurrence and tumor progression rate after endoscopic resection of superficial transitional cell carcinoma of the bladder. There were 27 recurrences in 22 of 67 evaluable patients (33%) who received BCG, compared to 27 recurrences in 19 of 33 control patients (58%) (p less than 0.05). The mean follow-up periods for the tumor-free patients in the BCG and control groups were 29 and 30 months, respectively, while the mean times to tumor recurrences for the above groups were 13.36 +/- 6 and 9.94 +/- 5 months, respectively (p less than 0.05). The recurrence rates per 100 patient months for the BCG and control patients were 1.69 and 4.41 recurrences, respectively (p less than 0.05), while 7 patients of the BCG group showed recurrent tumors of higher stage or grade, compared to 13 of the controls (p less than 0.05). This study confirms that Pasteur strain BCG is safe and efficacious in the prevention of superficial bladder tumor recurrence and tumor progression.     

Immunological therapy of recurrent urinary tract infections with immunoactive E. coll fractions in women

The efficacy of Uro-Vaxom®, an orally administered immunostimulatory extract of E. coli, was studied in 89 female patients with recurrent urinary tract infection (UTI). 74 patients with lower UTI and 15 with upper UTI were treated for 3 months with Uro-Vaxom®, 1 capsule daily, initially administered together with an antimicrobial at conventional dosage. During a follow up period of 6 months there was a statistically significant decrease in the incidence of reinfection in patients with lower UTI. During a further observation period of 6–18 months, the protective action of Uro-Vaxom® gradually diminished. An extension of the infection-free interval was registered in 18 patients with lower UTI who received a booster with Uro-Vaxom® 3 months after discontinuation of the initial immunostimulation, these patients showing the lowest recurrence rate. Uro-Vaxom® was well tolerated, with temporarily slight gastrointestinal side effects in only 2 patients.     

Change in urodynamic pattern and incidence of urinary tract infection in patients with traumatic spinal cord injury practicing clean self-intermittent catheterization

Objective: To observe changes in cystometric parameters in individuals with spinal cord injury (SCI) with neurogenic bladder practicing clean intermittent self-catheterization (CIC) and incidence of urinary tract infection (UTI) in such patients.

Design: Prospective, observational study.

Setting: Tertiary Urban Rehabilitation Hospital.

Participants: Persons with neurogenic bladder caused by traumatic SCI and practicing CIC.

Interventions: Clinical evaluation, complete urine analysis, urine culture and sensitivity, ultrasonography of the abdomen and urodynamic study were evaluated at baseline and at follow-up (6 months to 1 year).

Outcome Measures: Detrusor pattern, cystometric capacity, detrusor compliance, detrusor leak point pressure, residual urine, incidence of UTI.

Results: Thirty-one participants were included in the study. The baseline cystometric study showed that 15 had overactive detrusor and 16 had detrusor areflexia. The mean cystometric capacity decreased significantly between baseline and follow-up in both the groups but remained within the normal threshold limit, decline being more marked in the overactive detrusor group, who also had more marked decrease in compliance. Mean detrusor leak point pressure was below 40?cm H₂O in all participants in both groups at baseline and follow-up. Mean residual urine improved at follow-up in both groups. Incidence of UTI was 2.29 episodes per patient per year, and more frequent in the overactive detrusor group. Escherichia coli was the causative agent in 45%.

Conclusion: The cystometric capacity and compliance decreased significantly though patients were doing regular CIC and managed on antimuscarinics for detrusor overactivity (DO). UTI is more common in individuals with SCI with DO and E. coli is the most common cause of UTI.     

Kelfiprim versus co-trimoxazole in recurrent and persistent urinary tract infections: multicenter double-blind trial

Kelfiprim (KP) is a new bactericidal agent containing trimethoprim (T) and sulfametopyrazine (S), a long-acting sulfonamide (ratio 5:4). The posology is one capsule (T 250 mg + S 200 mg) daily, after a loading dose of two capsules on the first day. To evaluate the clinical value of Kelfiprim (KP) vs co-trimoxazole (CO) in urinary tract infection (UTI) a controlled multicenter double-blind trial (MDBT) was carried out in 76 patients suffering from persistent and recurrent UTIs. About 90 per cent response rate (sterile urine at the end of treatment) was obtained for KP and about 85 per cent for CO in recurrent UTI. In persistent UTI the rate of recovery was 66.8 per cent and 53 per cent for KP and CO, respectively. Safety of treatments was excellent in 97 per cent of patients treated with Kelfiprim and 87 per cent treated with co-trimoxazole. Two patients, one in each group, were dropped from the study because of adverse reactions.     

Clinical evaluation of ofloxacin in the treatment of acute cystitis

Ofloxacin (OFLX) was administered to 236 female patients with acute cystitis. Of them 164 patients who satisfied the criteria proposed by the UTI Committee, Japan were examined for the efficacy of the treatment, but all cases were included in the study of the side effects of the drug. In the 65 patients who received 300 mg (3 divided doses) of OFLX per day, the overall clinical efficacy was excellent in 66.2% and moderate in 33.8% of the patients. In the 99 patients who received 600 mg (3 divided doses) of OFLX per day, the overall clinical efficacy was excellent in 79% (P less than 0.076) and moderate in 18.2% of the patients. No failure of the treatment was observed in the two groups. Of 164 bacterial strains isolated from the urine of the patients, 132 strains were identified as E. coli. All bacterial strains were eradicated in the urinary specimens by the treatment. Subjective side effects were observed in 8 (3.4%) of the 236 patients. Gastrointestinal disturbance was complained by 6 patients. No drug-related aggravation in the laboratory test was observed except for one patient who showed mild leukopenia reduced from 3700/mm3 to 2200/mm3. These results showed that the oral administration of OFLX was excellent and satisfactory in the treatment for acute cystitis.     

国产羟乙膦酸钠防治原发性骨质疏松症的临床观察

目的 观察国产羟乙膦酸钠治疗骨质疏松症的疗效。方法 羟乙膦酸钠组６８例,服羟乙膦酸钠二疗程其共６个月,对照组４８例;２组每日均服碳酸钙０．６ｇ,维生素Ｄ１２５单位,连续半年,结果 羟乙膦酸钠组腰椎及髋部ＢＭＤ均升高,骨痛明显改善,与此同时,血清碱性磷酸酶、骨钙素、酸性磷酸酶及尿吡啶酚／肌酐比值明显降低,对照组用药前后无明显改变。不良反应轻。结论 羟乙膦酸钠是治疗原发性骨质疏松症安全、有效、方便、经     

Effective prophylaxis of recurrent urinary tract infections in premenopausal women by postcoital administration of cephalexin

A total of 31 sexually active premenopausal women, prone to have recurrent urinary tract infections but who otherwise were healthy, underwent postcoital prophylaxis consisting of a single oral dose of 250 mg. cephalexin. While 127 urinary tract infections occurred in these patients during a mean of 6 months before treatment, only 1 occurred during a mean of 12 months after postcoital cephalexin prophylaxis. This difference was statistically highly significant. Each of these patients ingested approximately 120 cephalexin tablets per year of postcoital prophylaxis. Postcoital oral cephalexin prophylaxis is highly effective in the prevention of recurrent urinary tract infection in the nonpregnant as well as pregnant premenopausal women because of easy compliance, the high urine concentration achieved and the minimal induction of resistance to cephalexin in the introital gram-negative bacterial flora. Postcoital cephalexin prophylaxis achieves identical results to daily cephalexin prophylaxis but uses only a third of the tablets required in the daily regimens. Finally, cephalexin represents an additional valuable antibacterial drug in postcoital prophylaxis along with cotrimoxazole, nitrofurantoin and cinoxacin.