The penetration of ciprofloxacin into prostatic tissue was studied following oral administration of 500 mg either once or repeatedly in 12-hourly intervals. Following single administration ciprofloxacin was rapidly absorbed from the gastrointestinal tract peaking 1–2 h after administration. Elimination from serum was slow, the half life being 4.3 h. No significant rise in serum concentrations was noticed following repeated administration. Ciprofloxacin was concentrated in the prostatic tissue, levels being on average twice as high as the corresponding serum concentrations. The ratios between prostate and serum levels following single and repeated administration were 227 and 214%, respectively. Intraindividual analysis of prostate concentrations in different areas of the prostatic gland revealed a homogenous distribution within the prostate. Penetration of ciprofloxacin into prostatic fluid was studied in 11 patients 2-4.5 h after administration. At these points ratios between prostatic fluid and serum ranged between 1.5 and 450%.

In an open study 28 patients were treated for complicated UTI with ciprofloxacin 250 mg every 12 h for 10 days. The most frequently isolated species were Escherichia coli and Klebsiella pneumoniae. All pathogens were sensitive to ciprofloxacin in vitro. Twenty-three of the 28 patients (82%) were free of infection 5-9 days after therapy. A persistent infection was noted in two patients (7%) and a reinfection in three patients (11%). Four to six weeks after the end of therapy, 18 patients (64%) were still totally free of infection. Clinical resolution of symptoms and signs occurred in 27 patients (96%). Adverse reactions were spontaneously reported by four of the 28 patients (14%) and by 11 (39%) after detailed inquiry. Most side effects were of gastrointestinal or neurological nature. This small open study supports the view, that ciprofloxacin may be useful in the treatment of complicated UTI.

SUMMARY Growing awareness of problems arising from over‐use of antimicrobial agents has led to attempts to develop policies or guidelines for rational treatment. To follow the effects of guidelines, the percentage of patients receiving antimicrobial drug therapy, acquired from patient records, has been a frequently used parameter. In this paper the Defined Daily Dose (DDD) per 100 bed‐days has been used instead. This parameter can be calculated by converting the number of units of antimicrobials, delivered to individual wards, to defined daily doses per bed‐day. This parameter determines the probability of treating a patient with a particular drug, based on pooled data. The DDD per 100 bed‐days has been used to follow changes in prescribing habits arising from the acceptance of and adherence to guidelines over a period of 5 years in a University Hospital.

The efficacy and tolerability of fosfomycin trometamol in a single dose of 3 g was compared with norfloxacin 400 mg b.i.d. for seven days in the treatment of adult female patients with uncomplicated urinary infections. 158 female patients with a mean age of 30 years who presented symptoms of dysuria and frequency with documented pyuria and bacteriuria on urinalysis (greater than or equal to 10(5) cfu/ml of urine) were initially included in the study. The total number of clinically and bacteriologically evaluable patients was 111, of which 61 received fosfomycin trometamol and 50 norfloxacin. One to two days after the double blind medication schedule for seven days, 55 of 60 patients (92%) in the fosfomycin trometamol group and 48 of 50 patients (96%) in the norfloxacin group were clinically cured. 37 patients without significant bacteriuria showed a clinical cure rate of over 90% in both therapy groups. Two to three days after the single dose treatment with fosfomycin trometamol the initial infecting pathogen was eradicated in 60 of the 61 patients (98%). One to two days after a seven day treatment with norfloxacin 48 of 50 patients (96%) showed an eradication of the initial infecting pathogen. Six weeks after the start of therapy 39/60 patients (65%) and 32/49 (65%) in the fosfomycin trometamol and norfloxacin groups respectively, remained free from urinary infection. The reinfection rate in both treatment groups was approximately 25%. The relapse rate in the post treatment evaluation period of four weeks was relatively low in both therapy groups, 5/49 patients (10%) in the norfloxacin group and 3/55 patients (6%) in the fosfomycin trometamol group, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

One hundred and four patients with complicated urinary tract infections (prolonged severe chronic infections or with complicated postoperative conditions) were treated for ten days with pefloxacin 400 mg bid. Bacteriological eradication of the initial pathogen was achieved in 98% of the patients. After six weeks 93% of the patients were still free of the initial infecting microorganism. Clinical improvement was achieved in 77% of the patients five to seven days after cessation of treatment. The side-effects which were definitely related to pefloxacin occurred in 9% of patients and were mostly of a gastro-intestinal, a neurological, or an allergic nature. No significant biochemical or haematological adverse reactions occurred.