Level 2: Mid-level evidence

A systematic Cochrane review evaluated 15 randomized trials comparing different durations of oral antibiotics for the treatment of uncomplicated symptomatic lower UTIs in 1,644 elderly women (Cochrane Database Syst Rev. 2008;[3]:CD001535). Most trials included in the review had low methodologic quality.

Comparing short-course (3-6 days) vs. longer treatments (7-14 days), there were no significant differences in efficacy or clinical outcomes. A single-dose regimen (compared with short- or long-course) was associated with persistence of UTI but no differences in long-term follow-up or clinical outcomes. This study suggests that the short-course treatment used in younger women can be extended to elderly women as well.