Randomized, double-blind comparison of ciprofloxacin and trimethoprim-sulfamethoxazole for complicated urinary tract infections

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.

[1]  J. Waitz Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically , 1990 .

[2]  A. M. Battaglia,et al.  Ofloxacin vs. cotrimoxazole in patients with complicated urinary tract infections. , 1987, International journal of clinical pharmacology, therapy, and toxicology.

[3]  L. Preheim,et al.  Oral ciprofloxacin in the treatment of elderly patients with complicated urinary tract infections due to trimethoprim/sulfamethoxazole-resistant bacteria. , 1987, The American journal of medicine.

[4]  L. Preheim,et al.  CIPROFLOXACIN AND ANTACIDS , 1986, The Lancet.

[5]  J. Golomb,et al.  Concentration of ciprofloxacin in human prostatic tissue after oral administration , 1986, Antimicrobial Agents and Chemotherapy.

[6]  E Abrutyn,et al.  Epidemiology of bacteriuria in an elderly ambulatory population. , 1986, The American journal of medicine.

[7]  J. Sabbaj,et al.  Norfloxacin versus co-trimoxazole in the treatment of recurring urinary tract infections in men. , 1986, Scandinavian journal of infectious diseases. Supplementum.

[8]  H. Muytjens,et al.  Efficacy and safety of ciprofloxacin (Bay 0 9867) in the treatment of patients with complicated urinary tract infections. , 1985, The Journal of antimicrobial chemotherapy.

[9]  A. Smith,et al.  Pharmacokinetics of three oral formulations of ciprofloxacin , 1985, Antimicrobial Agents and Chemotherapy.

[10]  B. Joos,et al.  Comparison of high-pressure liquid chromatography and bioassay for determination of ciprofloxacin in serum and urine , 1985, Antimicrobial Agents and Chemotherapy.

[11]  H. Goossens,et al.  Comparative in vitro activities of aztreonam, ciprofloxacin, norfloxacin, ofloxacin, HR 810 (a new cephalosporin), RU28965 (a new macrolide), and other agents against enteropathogens , 1985, Antimicrobial Agents and Chemotherapy.

[12]  H. Lode,et al.  Pharmacokinetics of ciprofloxacin after oral and parenteral administration , 1985, Antimicrobial Agents and Chemotherapy.

[13]  F. Debruyne,et al.  Ciprofloxacin distribution in prostatic tissue and fluid following oral administration. , 1985, Chemotherapy.

[14]  H. Neu,et al.  Ciprofloxacin, a quinolone carboxylic acid compound active against aerobic and anaerobic bacteria , 1984, Antimicrobial Agents and Chemotherapy.

[15]  C. Sheldon,et al.  Differentiation of upper and lower urinary tract infections: how and when? , 1984, The Medical clinics of North America.

[16]  G. Eliopoulos,et al.  In vitro activity of ciprofloxacin, a new carboxyquinoline antimicrobial agent , 1984, Antimicrobial Agents and Chemotherapy.

[17]  J. Hamilton-miller,et al.  ANTIBODY-COATED BACTERIA IN URINE: CRITERION FOR A POSITIVE TEST AND ITS VALUE IN DEFINING A HIGHER RISK OF TREATMENT FAILURE , 1983, The Lancet.

[18]  R. Gleckman,et al.  Therapy of recurrent invasive urinary-tract infections of men. , 1979, The New England journal of medicine.

[19]  W. P. Reed,et al.  Recurrent urinary tract infections in men. Characteristics and response to therapy. , 1979, Annals of internal medicine.