Randomized, Double-blind Comparison of Ciprofloxacin and Trimethoprim-sulfamethoxazole for Complicated Urinary Tract Infections

Overview

Journal Antimicrob Agents Chemother

Publisher American Society for Microbiology

Specialty Pharmacology

Date 1988 Sep 1

PMID 3195995

Citations 11

Authors

J M Allais

L C Preheim

T A Cuevas

J S Roccaforte

M A Mellencamp

M J Bittner

Affiliations

Soon will be listed here.

Abstract

In a prospective, randomized, double-blind study, the effect of ciprofloxacin (250 mg orally, twice daily) was compared with that of trimethoprim-sulfamethoxazole (160 mg of trimethoprim and 800 mg of sulfamethoxazole orally, twice daily) on 45 patients with complicated urinary tract infections. Pretherapy isolates were all members of the family Enterobacteriaceae. Isolates were eradicated from 18 (82%) of 22 patients treated with ciprofloxacin and 12 (52%) of 23 patients treated with trimethoprim-sulfamethoxazole during and 5 to 9 days after therapy (P = 0.035). Both groups had similar relapse and reinfection rates at 4 to 6 weeks posttherapy. Adverse effects were mild and reversible, occurring in 1 of 22 in the ciprofloxacin group and 6 of 23 in the trimethoprim-sulfamethoxazole group. Disk diffusion susceptibility tests correlated better with broth macrodilution for ciprofloxacin than for trimethoprim-sulfamethoxazole. Ciprofloxacin is a safe, effective alternative to trimethoprim-sulfamethoxazole for the treatment of complicated urinary tract infections.

Citing Articles

The 6R's of drug induced nephrotoxicity.

Awdishu L, Mehta R BMC Nephrol. 2017; 18(1):124.

PMID: 28372552 PMC: 5379580. DOI: 10.1186/s12882-017-0536-3.

Comparative effectiveness of different oral antibiotics regimens for treatment of urinary tract infection in outpatients: an analysis of national representative claims database.

Lee M, Lee S, Chang S, Lee S, Lee M, Fang C Medicine (Baltimore). 2014; 93(28):e304.

PMID: 25526477 PMC: 4603088. DOI: 10.1097/MD.0000000000000304.

Systematic review and meta-analysis of antimicrobial treatment effect estimation in complicated urinary tract infection.

Singh K, Li G, Mitrani-Gold F, Kurtinecz M, Wetherington J, Tomayko J Antimicrob Agents Chemother. 2013; 57(11):5284-90.

PMID: 23939900 PMC: 3811298. DOI: 10.1128/AAC.01257-13.

Quinolone antibacterial agents for the treatment of genitourinary tract infections.

Babinchak T, Fass R Eur J Clin Microbiol Infect Dis. 1989; 8(12):1111-6.

PMID: 2695332 DOI: 10.1007/BF01975178.

Treatment of genitourinary tract infections with fluoroquinolones: clinical efficacy in genital infections and adverse effects.

Hooper D, Wolfson J Antimicrob Agents Chemother. 1989; 33(10):1662-7.

PMID: 2686546 PMC: 172734. DOI: 10.1128/AAC.33.10.1662.

References

Gleckman R, Crowley M, NATSIOS G . Therapy of recurrent invasive urinary-tract infections of men. N Engl J Med. 1979; 301(16):878-80. DOI: 10.1056/NEJM197910183011607. View

VELLUCCI A, Bernardini G, Battaglia A, Battaglia P . Ofloxacin vs. cotrimoxazole in patients with complicated urinary tract infections. Int J Clin Pharmacol Ther Toxicol. 1987; 25(5):279-81. View

Kaye D . Urinary tract infections in the elderly. Bull N Y Acad Med. 1980; 56(2):209-20. PMC: 1805129. View

Gargan R, Brumfitt W, Hamilton-Miller J . Antibody-coated bacteria in urine: criterion for a positive test and its value in defining a higher risk of treatment failure. Lancet. 1983; 2(8352):704-6. DOI: 10.1016/s0140-6736(83)92247-x. View

Sheldon C, Gonzalez R . Differentiation of upper and lower urinary tract infections: how and when?. Med Clin North Am. 1984; 68(2):321-33. DOI: 10.1016/s0025-7125(16)31133-6. View

Chin N, Neu H . Ciprofloxacin, a quinolone carboxylic acid compound active against aerobic and anaerobic bacteria. Antimicrob Agents Chemother. 1984; 25(3):319-26. PMC: 185508. DOI: 10.1128/AAC.25.3.319. View

Eliopoulos G, Gardella A, Moellering Jr R . In vitro activity of ciprofloxacin, a new carboxyquinoline antimicrobial agent. Antimicrob Agents Chemother. 1984; 25(3):331-5. PMC: 185510. DOI: 10.1128/AAC.25.3.331. View

Boerema J, Dalhoff A, Debruyne F . Ciprofloxacin distribution in prostatic tissue and fluid following oral administration. Chemotherapy. 1985; 31(1):13-8. DOI: 10.1159/000238308. View

Joos B, Ledergerber B, Flepp M, Bettex J, Luthy R, Siegenthaler W . Comparison of high-pressure liquid chromatography and bioassay for determination of ciprofloxacin in serum and urine. Antimicrob Agents Chemother. 1985; 27(3):353-6. PMC: 176276. DOI: 10.1128/AAC.27.3.353. View

10.

Hoffken G, Lode H, Prinzing C, Borner K, Koeppe P . Pharmacokinetics of ciprofloxacin after oral and parenteral administration. Antimicrob Agents Chemother. 1985; 27(3):375-9. PMC: 176280. DOI: 10.1128/AAC.27.3.375. View

11.

Goossens H, De Mol P, Coignau H, Levy J, Grados O, Ghysels G . Comparative in vitro activities of aztreonam, ciprofloxacin, norfloxacin, ofloxacin, HR 810 (a new cephalosporin), RU28965 (a new macrolide), and other agents against enteropathogens. Antimicrob Agents Chemother. 1985; 27(3):388-92. PMC: 176282. DOI: 10.1128/AAC.27.3.388. View

12.

Davis R, Koup J, Weber A, Smith A . Pharmacokinetics of three oral formulations of ciprofloxacin. Antimicrob Agents Chemother. 1985; 28(1):74-7. PMC: 176313. DOI: 10.1128/AAC.28.1.74. View

13.

Boerema J, Boll B, Muytjens H, Branolte J . Efficacy and safety of ciprofloxacin (Bay 0 9867) in the treatment of patients with complicated urinary tract infections. J Antimicrob Chemother. 1985; 16(2):211-7. DOI: 10.1093/jac/16.2.211. View

14.

Boscia J, Kobasa W, Knight R, Abrutyn E, Levison M, Kaye D . Epidemiology of bacteriuria in an elderly ambulatory population. Am J Med. 1986; 80(2):208-14. DOI: 10.1016/0002-9343(86)90011-2. View

15.

Preheim L, Cuevas T, Roccaforte J, Mellencamp M, Bittner M . Ciprofloxacin and antacids. Lancet. 1986; 2(8497):48. DOI: 10.1016/s0140-6736(86)92596-1. View

16.

Dan M, Golomb J, Gorea A, BRAF Z, Berger S . Concentration of ciprofloxacin in human prostatic tissue after oral administration. Antimicrob Agents Chemother. 1986; 30(1):88-9. PMC: 176441. DOI: 10.1128/AAC.30.1.88. View

17.

Sabbaj J, Hoagland V, Cook T . Norfloxacin versus co-trimoxazole in the treatment of recurring urinary tract infections in men. Scand J Infect Dis Suppl. 1986; 48:48-53. View

18.

Preheim L, Cuevas T, Roccaforte J, Mellencamp M, Bittner M . Oral ciprofloxacin in the treatment of elderly patients with complicated urinary tract infections due to trimethoprim/sulfamethoxazole-resistant bacteria. Am J Med. 1987; 82(4A):295-300. View

19.

Smith J, Jones S, REED W, Tice A, DEUPREE R, Kaijser B . Recurrent urinary tract infections in men. Characteristics and response to therapy. Ann Intern Med. 1979; 91(4):544-8. DOI: 10.7326/0003-4819-91-4-544. View