Failure of a Single Dose of 100 mg Ofloxacin in Lower Urinary Tract Infections in Females

Ode, Björn; Walder, Mats; Forsgren, Arne

doi:10.3109/00365548709117203

Cited by 28 publications

(6 citation statements)

References 4 publications

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“…In the present clinical study Escherichia coli, Proteus mirabilis and staphylococci were, as expected, the most frequent causative pathogens. Not only S. saprophyticus (n = 1), as in other studies [17], but also S. aureus (n = 2), S. epidermidis (n=4), S. haemolyticus ( n = l ) and S. hominis (n = 2) were found to be present at baseline.…”

Section: Resultssupporting

confidence: 72%

Cefuroxime axetil versus ofloxacin for short-term therapy of acute uncomplicated lower urinary tract infections in women

Naber

Koch²

1993

Infection

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In a multicentre study 163 women with acute lower urinary tract infection were treated orally with either 125 mg cefuroxime axetil or 100 mg ofloxacin twice daily for three days. Both antimicrobial agents were generally well tolerated. Four patients in the group treated with cefuroxime axetil and two in the group treated with ofloxacin experienced adverse events. Clinical cure and improvement were registered in 56 of 66 (84.8%) and 59 of 62 (95.2%) of the evaluable patients treated with cefuroxime axetil and ofloxacin, respectively. Seven to nine days after therapy, bacteriuria (CFU < 10(3)/ml) had been eliminated in 53 of 66 (80.3%) and 57 of 64 (89.1%) of the evaluable patients receiving cefuroxime axetil and ofloxacin, respectively. The results were not statistically significantly different (p > 0.1). Pathogens present at baseline were eliminated by up to an MIC of 16 mg/l of cefuroxime axetil, independent of susceptibility to this agent. There was no difference with regard to efficacy and tolerance between patients treated with cefuroxime axetil and those treated with ofloxacin. On the basis of the MICs of six antimicrobial agents (cefuroxime, ofloxacin, cefadroxil, ampicillin, trimethoprim with and without sulfamethoxazole) determined for the pathogens isolated prior to therapy, resistance rates were lowest for cefuroxime (2.2%) and ofloxacin (3.4%).

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Section: Resultssupporting

confidence: 72%

Cefuroxime axetil versus ofloxacin for short-term therapy of acute uncomplicated lower urinary tract infections in women

Naber

Koch²

1993

Infection

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“…Ofloxacin in a 100-mg single-dose regimen resulted in an 80% cure rate 4 weeks after treatment in one uncontrolled study (18) and an 86% cure rate in another study with an unstated follow-up interval (13). In another study with an unstated follow-up interval, the cure rate in women treated with a 100-mg single-dose regimen of ofloxacin was significantly lower (73%) than that in the comparison group treated with a longer regimen of trimethoprim-sulfamethoxazole (93%) (16). While these observed cure rates are similar to those in our single-dose ofloxacin group, they are inferior to cure rates we have observed with short or conventional regimens of trimethoprim-sulfamethoxazole for uncomplicated cystitis (5,9).…”

Section: Resultsmentioning

confidence: 95%

Single-dose and three-day regimens of ofloxacin versus trimethoprim-sulfamethoxazole for acute cystitis in women

Hooton

Johnson

Winter

et al. 1991

Antimicrob Agents Chemother

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We compared the safety and efficacy of a single 400-mg dose of ofloxacin, ofloxacin (200 mg) once daily for 3 days, and trimethoprim-sulfamethoxazole (160:800 mg) twice daily for 7 days for the treatment of acute uncomplicated cystitis (urinary tract infection [UTI]) in women. At 5 weeks posttreatment, 35 (81%) of 43 patients treated with single-dose ofloxacin, 40 (89%) of 45 treated with 3 days of ofloxacin, and 41 (98%) of 42 treated with trimethoprim-sulfamethoxazole were cured (P = 0.03, single-dose ofloxacin group versus trimethoprim-sulfamethoxazole group). Retreatment for symptomatic recurrent UTI was given to 7 (16%) of 43 patients initially treated with single-dose ofloxacin, 3 (7%) of 45 patients treated with 3 days of ofloxacin, and 0 of 42 patients treated with trimethoprim-sulfamethoxazole (P = 0.01, single-dose ofloxacin group versus trimethoprim-sulfamethoxazole group). There was a trend in each of the three treatment groups toward an association between persistent or recurrent episodes of significant bacteriuria and a history of UTI in the past year and with diaphragm use. Ofloxacin was more effective than trimethoprim-sulfamethoxazole in eradicating Escherichia coli from rectal cultures during or soon after therapy, but there were no differences at later follow-up visits. Adverse effects were equally common among the three treatment groups. We conclude that single-dose ofloxacin was less effective than 7 days of trimethoprim-sulfamethoxazole for treatment of uncomplicated cystitis in women, while the 3-day ofloxacin regimen and the trimethoprim-sulfamethoxazole regimen were not significantly different in efficacy.The majority of cases of acute cystitis in young healthy women are effectively treated with conventional oral antimicrobial agents such as trimethoprim-sulfamethoxazole or nitrofurantoin. Ampicillin and sulfonamides have become less reliable in such cases because of the high prevalence of resistance to these agents among common uropathogens (10). The new fluoroquinolone antimicrobial agents, of which ofloxacin is one, have also been demonstrated to be effective for treatment of cystitis (24). While these agents are not considered the treatment of choice for uncomplicated cystitis, they are often used in patients who are intolerant of conventional agents, who have resistant pathogens, or in whom the presence of a complicating factor is more likely.Single-dose or 3-day regimens of antimicrobial agents are becoming increasingly popular for the treatment of uncomplicated cystitis because, compared with conventional regimens, they tend to be as effective and are associated with fewer adverse effects, better compliance, and lower cost (10). However, there are no published data on the use of the new fluoroquinolones in single-dose regimens for the treatment of uncomplicated cystitis in the United States. We therefore compared the safety and efficacy of ofloxacin in a single-dose regimen with a regimen of once-daily doses of ofloxacin for 3 days and with a conventional 7-day regimen of trimet...

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“…For fluoroquinolone antimicrobials, single-dose therapy is highly effective for E. coli. The poorer outcomes with single-dose fluoroquinolone therapies reported in some clinical trials may be largely attributable to the lower efficacy of single-dose therapy for Staphylococcus saprophyticus infection [9,22]. This is thought to be explained by a more prolonged time required for S. saprophyticus killing in urine.…”

Section: Single-dose Therapymentioning

confidence: 99%

Short-term therapy for urinary tract infection: success and failure

Nicolle

2008

International Journal of Antimicrobial Agents

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Failure of a Single Dose of 100 mg Ofloxacin in Lower Urinary Tract Infections in Females

Abstract: A single dose of 100 mg ofloxacin was compared with a multiple dose of cotrimoxazole in lower urinary tract infections in 137 women. The elimination rate was significantly lower in the single dose treated group of patients in spite of all strains being in vitro susceptible in this group.

Cited by 28 publications

References 4 publications

Cefuroxime axetil versus ofloxacin for short-term therapy of acute uncomplicated lower urinary tract infections in women

Cefuroxime axetil versus ofloxacin for short-term therapy of acute uncomplicated lower urinary tract infections in women

Single-dose and three-day regimens of ofloxacin versus trimethoprim-sulfamethoxazole for acute cystitis in women

Short-term therapy for urinary tract infection: success and failure

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