Norfloxacin, amoxycillin, cotrimoxazole and nalidixic acid: A summary of 3-day and 7-day therapy studies in the treatment of urinary tract infections

Vogel, Roger; Deaney, N. B.; Round, Elizabeth; Vandenburg, M. J.; Currie, W. J. C.

doi:10.1093/jac/13.suppl_b.113

Cited by 31 publications

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“…When norfloxacin was compared with nalidixic acid and pipemidic acid, norfloxacin was significantly more effective [18,61]. Finally, norfloxacin was slightly, but not significantly, more effective than amoxicillin for the treatment of uncomplicated UTI in geriatric patients [62].…”

Section: S155mentioning

confidence: 99%

Comparative Studies of Fluoroquinolones in the Treatment of Urinary Tract Infections

Malinverni

Glauser

1989

Journal of Urology

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The resultsof comparative trials of fluoroquinolones for the treatment of uncomplicated and complicated urinary tract infections (UTI) were reviewed. Severalrandomized, comparative trials showedthat in uncomplicated UTI norfloxacin, ciprofloxacin, and ofloxacin wereat least as effectiveas trimethoprim-sulfamethoxazole (TMP-SMZ) and amoxicillinand usually more effectivethan nalidixicacid, pipemidic acid, and nitrofurantoin. Comparativetrials of single-dose regimens have, however, been limited. A few randomized, comparative trials have shown that in complicated UTI norfloxacin, ciprofloxacin, and ofloxacin wereat least as effectiveas amoxicillinand TMP-SMZand usually more effective than pipemidic acid. Moreover, preliminary results indicate that fluoroquinolones might be effective for the oral treatment of complicated UTI that are difficult to treat, especially those due to Pseudomonas aeruginosa. Comparative trials are needed to establish the value of fluoroquinolones for chronic bacterial prostatitis. There are no conclusivedata on fluoroquinolone treatment of UTI in patients with renal failure. Emergence of resistantpathogens during therapywith fluoroquinolones has beeninfrequentbut might be more frequent in complicated UTI caused by P. aeruginosa.Although highly effective and well-established antibiotic regimens are available for the treatment of urinary tract infection (UTI), there is a need for new antimicrobial agents, especially for the treatment of outpatients with UTI that are difficult to treat and for which most of the drugs available for oral treatment are ineffective.The fluoroquinolones have several properties that suggest their potential clinical utility for the treatment of UTI, including high activity in vitro against virtually all urinary tract pathogens and good absorption after oral administration that results in prolonged high levels of drug in urine [1].The methodologic problems associated with open and comparative trials evaluating the efficacy of new antibiotics for the treatment of UTI have recently been reviewed [2]. For this review of the efficacy of fluoroquinolones for the treatment of UTI, we have emphasized those studies that have both sufficient data for a clear classification of UTI and data on We thank Mrs. Kathrin Zsirmik and Mrs. Alexandra Bloch for typing the manuscript.Please address requests for reprints to R. Malinverni, Medizinische Universitatsklinik, Inselspital, CH-3010 Bern, Switzerland. follow-up urine cultures 4-6 weeks after the end of treatment (unless otherwise mentioned). In this evaluation, bacteriologic cure (sterile urine) was considered as the end point of antibiotic treatment since the definitions of clinical response, when stated, varied from one study to another and symptoms may disappear in the absence of bacteriologic cure. In table 1, which outlines the efficacy of fluoroquinolone treatment of UTI by infecting organism, only data from studies (noncomparative and comparative) that provided sufficient information to permit a clear classification of UTI...

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Section: S155mentioning

confidence: 99%

Comparative Studies of Fluoroquinolones in the Treatment of Urinary Tract Infections

Malinverni

Glauser

1989

Journal of Urology

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“…[8][9][10] Serious side effects from norfloxacin included severe gastrointestinal effects and central nervous system effects. 8,[20][21][22] Costs. From a societal perspective, the data on direct medical costs in 1999 U.S. dollars (Table 2) were collected, including costs of antibiotic therapies, treating adverse reactions from antibiotics, inpatient treatment, ED visits, and office visits.…”

Section: Study Setting and Populationmentioning

confidence: 99%

A Cost–Effectiveness Analysis of Treatment Strategies for Acute Uncomplicated Pyelonephritis in Women

Yen

Davis

Chen

et al. 2003

Academic Emergency Medicine

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At least 250,000 episodes of acute uncomplicated pyelonephritis are treated annually in the emergency department (ED). Trimethoprim-sulfamethoxazole (TMP-SMX) and norfloxacin have both been used as treatments for acute uncomplicated pyelonephritis. Objectives: To investigate the cost-effectiveness of two outpatient treatment strategies, TMP-SMX and norfloxacin, for acute uncomplicated pyelonephritis in adult women between the ages of 18 and 65 years. Methods: Common principles of cost-effectiveness analysis were used for this evaluation. The authors developed a decision tree to estimate the costs and effectiveness of two different treatment strategies: TMP-SMX 160/ 800 mg twice per day for 10 days and norfloxacin 400 mg twice per day for 10 days. The time frame of the decision tree was 11 days. Outcomes were expressed in U.S. dollars, quality-adjusted life-days (QALDs), and dollars per QALD. Sensitivity analyses were performed on most variables. Results: Norfloxacin is more effective and less costly than the alternative, TMP-SMX. Norfloxacin treatment will save $195.85 per patient, resulting in an aggregate saving of more than $40 million annually. Patients are expected to enjoy a better quality of life with an incremental 0.0601 QALD per patient, if they are treated with norfloxacin. These results are robust across a wide range of probabilities and costs. Conclusions: In this analysis, norfloxacin 400 mg twice a day was a more cost-effective treatment than TMP/SMX 160/800 mg twice a day for women with pyelonephritis. Key words: costs; cost-benefit analysis; pyelonephritis; norfloxacin; trimethoprim-sulfamethoxazole. ACADEMIC EMERGENCY MEDICINE 2003; 10:309-314. Acute uncomplicated pyelonephritis is a common disease seen in the emergency department (ED). At least 250,000 episodes of acute pyelonephritis occur annually in the United States.1 The typical features are flank pain, fever and chills with dysuria, urgency, and frequency. Antibiotic treatment is necessary to control infection and prevent suppurative complications.Outpatient treatment is an effective and safe management for patients with acute uncomplicated pyelonephritis.2-7 Prior studies have focused on comparing efficacies of fluoroquinolones and trimethoprim-sulfamethoxazole (TMP-SMX). As an example, norfloxacin has been shown to be more effective for treating pyelonephritis than is TMP-SMX 8 -10 ; however, norfloxacin is significantly more expensive. Norfloxacin and TMP-SMX have, in the past, been recommended as outpatient medications for treating acute uncomplicated pyelonephritis in women, 3,4 but a trend of increasing resistance to TMP-SMX among Escherichia coli, especially among strains causing pyelonephritis, has been noted. 11,12The goal of this study was to consider how factors such as costs or quality of life might affect drug choices for treatment. We therefore developed a decision model to estimate the cost-effectiveness of alternative antibiotic strategies for women with acute uncomplicated pyelonephritis. For the purposes of t...

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“…In an open study comparing norfloxacin to trimethoprim/sulfame thoxazole, amoxicillin and nalidixic acid, the percents of isolates susceptible were 99.8 %, 94 %, 76 % and 86 %, respectively, for 503 isolates (35).…”

Section: Clinical Efficacymentioning

confidence: 99%

Quinolone antibacterial agents for the treatment of genitourinary tract infections

Babinchak

Fass

1989

Eur. J. Clin. Microbiol. Infect. Dis.

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The fluoroquinolones have expanded the therapeutic options available for the treatment of genitourinary tract infections. Their ease of oral administration, favourable pharmacokinetics, low incidence of adverse reactions, and broad spectrum of in vitro activity against aerobic and facultative organisms make them especially suitable for treating bacteriuria, particularly when pathogens are resistant to other available oral agents. Their efficacy has also been established in the treatment of prostatis, gonorrhea and chancroid. They have lower in vitro activity against chlamydia, ureaplasma and anaerobes, and their role in the treatment of non-gonococcal urethritis, vaginitis and acute pelvic inflammatory disease is less well established.

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Norfloxacin, amoxycillin, cotrimoxazole and nalidixic acid: A summary of 3-day and 7-day therapy studies in the treatment of urinary tract infections

Cited by 31 publications

References 0 publications

Comparative Studies of Fluoroquinolones in the Treatment of Urinary Tract Infections

Comparative Studies of Fluoroquinolones in the Treatment of Urinary Tract Infections

A Cost–Effectiveness Analysis of Treatment Strategies for Acute Uncomplicated Pyelonephritis in Women

Quinolone antibacterial agents for the treatment of genitourinary tract infections

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