In January of 1964 a 20-year prospective study of urinary tract infections was begun at the Southern California Permanente Medical Group in Panorama City, California. This paper is concerned with 368 females, aged 2 through 14 years, who had their first infection diagnosed between January 1964 and August 31, 1969.
No benefit could be demonstrated to Sulfisoxazole therapy exceeding 2 weeks for the first infection and 6 weeks for the second infection nor to treating with ampicillin instead of sulfisoxazole.
A higher recurrence rate was found in those patients who, at the time of the first infection, had minimal abnormalities on urinalysis, infection with an organism other than E. coli, fever, or no symptoms.
Recurrences of 40% and 60% were diagnosed after the first two infections respectively. Usually the patients with a recurrent infection were asymptomatic. It is therefore felt that the physician must take an active part in informing the patient of the need to return and contacting her if she fails to do so. The follow-up period should extend for at least 6 years after the last infection.