Oral ciprofloxacin in the treatment of elderly patients with complicated urinary tract infections due to trimethoprim/sulfamethoxazole-resistant bacteria
Abstract
The effectiveness and safety of ciprofloxacin, a new quinolone antibiotic, were prospectively evaluated in the treatment of patients with complicated urinary tract infections caused by gram-negative organisms resistant to trimethoprim/sulfamethoxazole. Twenty-five elderly (mean age, 70.4 years) patients (24 men and one woman) were enrolled. Initial pathogens included Pseudomonas aeruginosa (15 isolates), Escherichia coli (five isolates), Enterobacter aerogenes (one isolate), Citrobacter freundii (one isolate), Serratia species (two isolates), Proteus vulgaris (one isolate), and enterococcus (one isolate). Patients received 500 mg of ciprofloxacin orally twice daily for one week (mean, 6.98 days). Results of urine cultures obtained during therapy were negative in all cases, and at one week post-therapy, 21 of 25 (84 percent) infections were cured. Four patients experienced a relapse with P. aeruginosa. Repeat urine culture specimens were obtained at four to six weeks from 14 patients who had cures at one week post-therapy, and seven continued to have cures. Three patients had late relapses with P. aeruginosa, E. coli, or Serratia marcescens, and four were reinfected with new strains. Five patients who received concomitant oral antacids had lower mean peak and trough serum ciprofloxacin levels than did patients not receiving antacids (p less than 0.05, Wilcoxon rank sum test). Mild adverse effects were seen in seven patients: eosinophilia (one patient), eosinophilia and…
How strong is the evidence?
Evidence Hub reads this as a clinical trial, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 24 participants or records.
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