Norfloxacin versus cotrimoxazole in the treatment of uncomplicated urinary tract infections--a multi-centre trial

Abstract

One hundred and twenty-two patients with uncomplicated urinary tract infections were treated with either 400 mg bd norfloxacin or 160/800 mg bd cotrimoxazole for 7 days. Follow-up examinations showed norfloxacin to be equally effective as cotrimoxazole in the eradication of bacteriuria and symptoms. Norfloxacin caused fewer and less severe side effects.

The fluoroquinolones: pharmacology, clinical uses, and toxicities in humans

“…In each comparative study the adverse effects reported with norfloxacin were similar to (14,16,18,19,28,(34)(35)(36)40) (11,14,16,18,19,25,27,28,(34)(35)(36)40). Gastrointestinal symptoms (nausea, vomiting, anorexia) and central nervous system symptoms (lightheadedness, headache, drowsiness, insomnia) were the most frequently reported but rarely were severe or required cessation of therapy.…”

“…In the presence of meningeal inflammation, pefloxacin appears to penetrate well into the cerebrospinal fluid, reaching concentrations of 4.8 ± 0.79 ,ug/ml (44% that of serum) (47). Similar drug penetration into cerebrospinal fluid was also seen when pefloxacin was given after the recovery of patients from meningitis (47 [34][35][36]40). Norfloxacin, when given with one exception (14) in doses of 400 mg orally twice daily, demonstratqd significantly higher (35,36) or equivalent rates of cure when compared in eight randomized, nonblinded studies to orally administered trimethoprim-sulfamethoxazole (14,16,18,19,36,40), amoxicillin (28), or nalidixic acid (35) ( Table 2).…”

“…Similar drug penetration into cerebrospinal fluid was also seen when pefloxacin was given after the recovery of patients from meningitis (47 [34][35][36]40). Norfloxacin, when given with one exception (14) in doses of 400 mg orally twice daily, demonstratqd significantly higher (35,36) or equivalent rates of cure when compared in eight randomized, nonblinded studies to orally administered trimethoprim-sulfamethoxazole (14,16,18,19,36,40), amoxicillin (28), or nalidixic acid (35) ( Table 2). When specified (eight studies), most studies included only patients with uncomplicated infections (absence of catheters, structural defects in the urinary tract, or abnormal renal function) (11,14,16,19,25,(34)(35)(36).…”

“…In most instances the infecting organisms were Escherichia coli or other enteric gram-negative bacilli, but lesser numbers of urinary tract infections caused by Pseudomonas aeruginosa were also successfully treated (22 of 25 from three studies) (19,27,34). Among nine studies which assessed bacterial susceptibilities after treatment of 397 infected patients with norfloxacin (11,14,16,18,19,27,28,34,40), therapeutic failures were associated with the appearance of norfloxacin-resistant organisms in only four individuals (1.0%). These four cases included two reinfections, one with Streptococcus faecalis (11) and one with a group B streptococcus (16), one relapse with P. aeruginosa (27), and one relapse with E. coli having an MIC of 1 pug of norfloxacin per ml (28), a drug concentration still substantially.…”

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

“…[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.…”