Begin Bactrim prophylaxis only after confirming a documented history of recurrent urinary tract infections (UTIs) – at least two within six months or three within a year. This preventative measure targets susceptible E. coli strains, significantly reducing recurrence risk.
Prescribe Bactrim (sulfamethoxazole/trimethoprim) at a dosage of one double-strength tablet daily, taken at bedtime. This minimizes potential gastrointestinal side effects. Continue prophylaxis for a minimum of six months, carefully monitoring for any adverse reactions.
Regular urine cultures are not routinely necessary during prophylaxis, unless symptoms suggestive of UTI appear. However, consider a culture after three months of therapy to assess for bacterial resistance. Adjust treatment if resistance develops or symptoms persist despite prophylaxis.
Important Note: Bactrim prophylaxis is not suitable for all patients. Contraindications include known allergy to sulfonamides, significant renal impairment, and pregnancy. Always assess individual patient risk factors and discuss potential benefits and harms before initiating treatment. Regular follow-up appointments allow for prompt adjustment of treatment based on individual patient response.
