The value of routine antibiotic prophylaxis was assessed in 362 women undergoing lower urinary tract instrumentation. A three-day course of a once-a-day dose of 1 g of cefadroxil was compared with a three-day course of 100 mg of nitrofurantoin three times a day, in a randomized investigator blinded placebo controlled study. Both study drugs were significantly more effective in preventing postinstrumentation urinary tract infections than placebo (p < 0.003). Differences in efficacy between the two test drugs were not significant; however, side effects in the nitrofurantoin group were more frequent and severe than those in the cefadroxil group. Cefadroxil also offered the advantage of a once-daily dosing schedule.