SINGLE-DOSE PRULIFLOXACIN VERSUS SINGLE-DOSE PEFLOXACIN IN THE TREATMENT OF ACUTE UNCOMPLICATED URINARY TRACT INFECTION IN WOMEN

The aim of the study was to compare the efficacy and safety of singledose prulifloxacin vs. single-dose pefloxacin in the treatment of patients with acute uncomplicated urinary tract infections. Two hundred and thirty-one female out-patients were considered microbiologically evaluable and randomly treated with 600 mg prulifloxacin (116 patients) or 800 mg pefloxacin (115 patients). The most commonly isolated uropathogen at baseline was Escherichia coli (71.4%), followed by Proteus mirabilis (10.8%) and Klebsiella pneumoniae (7.8%). Five-seven days posttreatment, the eradication rate was 97.4% and 92.2% in the prulifloxacin and pefloxacin group, respectively. The one-tailed 95% confidence interval analysis showed the equivalence of treatments. Four weeks from treatment no relapses, reinfections or superinfections were observed. The clinical success rates were 92.2% in the prulifloxacin and 84.3% pefloxacin groups. The safety profile was very good with both drugs. The results of the study make it possible to consider prulifloxacin a possible therapeutic option in patients with acute uncomplicated UTIs.

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SINGLE-DOSE PRULIFLOXACIN VERSUS SINGLE-DOSE PEFLOXACIN IN THE TREATMENT OF ACUTE UNCOMPLICATED URINARY TRACT INFECTION IN WOMEN

Urogynaecologia ◽

10.4081/uij.2003.69 ◽

2010 ◽

Vol 17 (2) ◽

pp. 69 ◽

Cited By ~ 6

Author(s):

M. CERVIGNI ◽

G. ORTICELLI ◽

M. BOLOGNA ◽

F. NATALE ◽

E. SALVATORI ◽

...

Keyword(s):

Single Dose ◽

Urinary Tract ◽

Eradication Rate ◽

Clinical Success ◽

Therapeutic Option ◽

Uncomplicated Urinary Tract Infection ◽

Efficacy And Safety ◽

Success Rates ◽

The One ◽

Tract Infections

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Efficacy and Safety of a Novel, Single-dose Azithromycin Microsphere Formulation Versus 10 Days of Levofloxacin for the Treatment of Acute Bacterial Sinusitis in Adults

Otolaryngology ◽

10.1016/j.otohns.2005.04.020 ◽

2005 ◽

Vol 133 (2) ◽

pp. 194-200 ◽

Cited By ~ 32

Author(s):

John J. Murray ◽

Paz Emparanza ◽

Eugenijus Lesinskas ◽

Margaret Tawadrous ◽

Jeanne D. Breen

Keyword(s):

Single Dose ◽

Clinical Success ◽

Maxillary Sinusitis ◽

Efficacy And Safety ◽

Success Rates ◽

Radiographic Evidence ◽

Double Blind ◽

Acute Bacterial Sinusitis ◽

Cure Rates ◽

International Multicenter

Objective To compare the efficacy and safety of a single 2.0-g dose of a novel azithromycin microsphere formulation with that of 10 days of levofloxacin, 500 mg/d, when used to treat adults with uncomplicated acute bacterial maxillary sinusitis (ABS). Study Design and Setting An international, multicenter, randomized, double-blind, double-dummy trial. Eligible outpatients ≥18 years of age with clinical and radiographic evidence of ABS underwent maxillary sinus aspiration before randomization. Primary endpoint was clinical efficacy at the test-of-cure visit (day 17-24). Results Clinical success rates were 94.5% (242/256) in azithromycin-microspheres-treated patients and 92.8% (233/251) in the levofloxacin group. In patients with documented Streptococcus pneumoniae, Haemophilus influenzae, or Moraxella catarrhalis, clinical cure rates were 97.3% (36/37), 96.3% (26/27), and 100% (8/8), respectively, for the azithromycin group and 92.3% (36/39), 100% (30/30), and 90.9% (10/11), respectively, for the levofloxacin group. Conclusions Single-dose azithromycin microspheres provided clinical and bacteriologic efficacy and safety comparable to 10 days of levofloxacin. Significance A novel microsphere formulation of azithromycin given as a single dose was safe and effective for the treatment of ABS.

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Single-Dose versus Traditional Therapy for Uncomplicated Urinary Tract Infections

Drug Intelligence & Clinical Pharmacy ◽

10.1177/106002808802200103 ◽

1988 ◽

Vol 22 (1) ◽

pp. 21-24 ◽

Cited By ~ 5

Author(s):

George G. Zhanel ◽

Allan R. Ronald

Keyword(s):

Single Dose ◽

Urinary Tract ◽

Renal Involvement ◽

Published Data ◽

Uncomplicated Urinary Tract Infection ◽

Specific Test ◽

Traditional Therapy ◽

Dose Therapy ◽

Tract Infections ◽

Single Dose Therapy

In the treatment of uncomplicated urinary tract infection, single-dose therapy has appeared to be as efficacious as traditional 7-14 day therapy in women with cystitis without renal involvement. Current localizing techniques to differentiate between lower- and upper-tract disease are inadequate for routine clinical practice. As a result we have proposed that failure of cure with single-dose treatment may be the most specific test available to diagnose renal infection. Most of the published data on single-dose therapy involves treatment with either amoxicillin or trimethoprim-sulfamethoxazole. Single-dose therapy offers advantages over traditional therapy, including improved compliance, reduced adverse effects, and decreased cost. Appropriate patient selection is critical if the outcome of single-dose therapy is to be effective.

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2248. Clinical and Microbiological Outcomes Associated with Real-World Use of Ceftolozane/Tazobactam

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.1926 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S768-S769 ◽

Cited By ~ 1

Author(s):

Nicolo Cabrera ◽

Truc T Tran ◽

William R Miller ◽

An Q Dinh ◽

Blake Hanson ◽

...

Keyword(s):

Urinary Tract ◽

Real World ◽

Clinical Success ◽

Therapeutic Option ◽

Signs And Symptoms ◽

Outcome Data ◽

Advisory Board ◽

Hospital System ◽

Gram Negative ◽

Tract Infections

Abstract Background Ceftolozane/tazobactam (C/T) is a novel cephalosporin/β-lactamase inhibitor combination for treating Gram-negative infections, particularly Pseudomonas aeruginosa (PA). C/T has been FDA-approved for complicated intra-abdominal and urinary tract infections and has just completed a trial in ventilator nosocomial pneumonia, but real-world outcome data are still emerging. Methods Demographic, microbiologic, treatment and outcome data of patients who received C/T for ≥48 hours from January 2016 to August 2018 at multiple centers within a single hospital system were retrospectively collected. Available isolates were analyzed for C/T susceptibility (by Etest) and whole-genome sequencing (WGS). Spades v.3.11.1 was used for assembly, multi-locus sequence typing v2.10 performed for in silico MLST with the PubMLST database and Abricate v0.7 was used for resistance gene screening with the CARD database. Results Among 45 patients, 58% were non-white, 53% were female and 13% were immunocompromised. The median age was 64 years (IQR, 50 to 69). At the time of the index event, a high proportion of patients required ICU care (42%) and pressor support (13%) as well as had invasive devices in place (64%). A minority (2.4%) had prior exposure to C/T. Respiratory infections were most common (38%) followed by urinary tract (20%). Concomitant Gram-negative agents were used in 18%. 69% achieved clinical success (i.e., recovery from infection-related signs and symptoms). The in-hospital mortality rate was 16% of which 5 out of 7 were attributed to infection. Microbiology was available for 91% of patients; 84% had PA isolates resistant to at least 3 antipseudomonal classes (Figures 1 and 2). Ten PA isolates were analyzed with WGS (Table 1). C/T resistance arose during therapy in one patient (MIC increase from 1 to 128 µg/mL). WGS showed a substitution in AmpC β-lactamase (A46D) and presence of blaCARB-2. Conclusion Although C/T was used in a critically ill population with highly resistant organisms, cure rates were high and mortality was low. Acquired β-lactamases were not frequently seen among the PA isolates. C/T is a vital therapeutic option, particularly on MDR isolates for which options are limited. Disclosures Samuel L. Aitken, PharmD, Melinta Therapeutoics: Grant/Research Support, Research Grant; Merck, Sharpe, and Dohme: Advisory Board; Shionogi: Advisory Board.

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Levofloxacin Versus Ciprofloxacin in the Treatment of Urinary Tract Infections: Evidence-Based Analysis

Frontiers in Pharmacology ◽

10.3389/fphar.2021.658095 ◽

2021 ◽

Vol 12 ◽

Author(s):

Dehong Cao ◽

Yinzhi Shen ◽

Yin Huang ◽

Bo Chen ◽

Zeyu Chen ◽

...

Keyword(s):

Adverse Event ◽

Urinary Tract ◽

Urinary Tract Infections ◽

Eradication Rate ◽

Event Rate ◽

Clinical Success ◽

Clinical Success Rate ◽

Adverse Event Rate ◽

Evidence Based ◽

Tract Infections

Urinary tract infections (UTIs) are one of the most common bacterial infections acquired both in community and hospital. Fluoroquinolones, represented by levofloxacin and ciprofloxacin, are widely used for treatment of UTIs. However, it remains controversial for the comparison between the 2 drugs, which propelled us to conduct the first evidence-based research on this topic. To establish their relative efficacy and safety, we searched Pubmed, embase, and Web of Science for randomized controlled trials (RCTs) for UTIs. A total of 5 RCTs were finally included, involving 2,352 patients and a systematic review and meta-analysis were performed to compare the end-of-therapy and posttherapy clinical success rate, microbial eradication rate and adverse event rate. Jadad score and Review Manager 5.3.0 version were applied respectively to evaluate the study quality and heterogeneity. There was no significant difference between levofloxacin and ciprofloxacin group in end-of-therapy or posttherapy clinical success rate and microbial eradication rate (p > 0.05). As for adverse event rate, the 2 drugs were comparable and both safe for clinical use. Based on one included trial and pharmacological research, we raised hypothesis that levofloxacin was superior to ciprofloxacin for treatment of E. coli-induced chronic bacterial prostatitis (CBP) and it required a further study to prove it.

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Treatment of Community-Acquired Acute Uncomplicated Urinary Tract Infection with Sparfloxacin versus Ofloxacin

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.42.9.2262 ◽

1998 ◽

Vol 42 (9) ◽

pp. 2262-2266 ◽

Cited By ~ 26

Author(s):

D. Henry ◽

W. Ellison ◽

J. Sullivan ◽

D. L. Mansfield ◽

D. J. Magner ◽

...

Keyword(s):

Urinary Tract ◽

Urinary Tract Infections ◽

Uncomplicated Urinary Tract Infection ◽

Efficacy And Safety ◽

Open Label ◽

Once Daily ◽

Clinical Responses ◽

Tract Infections ◽

Cure Rates ◽

Bacteriologic Response

ABSTRACT The efficacy and safety of a 3-day regimen of sparfloxacin were compared with those of a 3-day regimen of ofloxacin for the treatment of community-acquired acute uncomplicated urinary tract infections. Four hundred nineteen women were enrolled in a randomized, open-label, observer-blinded, multicenter study; 204 received sparfloxacin as a 400-mg loading dose on the first day and 200 mg once daily thereafter, and 215 received ofloxacin as 200 mg twice daily. A total of 383 patients met the criteria for clinical evaluability, and 174 were also bacteriologically evaluable; all treated patients were included in the safety analysis. Escherichia coli (86%) andStaphylococcus saprophyticus (4.6%) were the organisms most commonly isolated. Positive clinical responses were obtained 5 to 9 days after therapy in more than 92% of the patients in each group; sustained clinical cure rates 4 to 6 weeks after therapy were 78.3 and 76.9% in the sparfloxacin and ofloxacin groups, respectively. A positive bacteriologic response was observed in 98% of the bacteriologically evaluable patients in each treatment group at 5 to 9 days posttherapy and in 88.2 and 92.6% of the patients in the sparfloxacin and ofloxacin groups, respectively, 4 to 6 weeks after therapy. Almost 90% of all adverse events were of mild or moderate severity; the most frequent events at least possibly related to drug treatment were those common to the fluoroquinolones, namely, nausea, diarrhea, headache, insomnia, and photosensitivity. Photosensitivity was more frequent in the sparfloxacin group (6.9% versus 0.5% in the ofloxacin group); insomnia was more frequent in the ofloxacin group (3.7% versus 1.0% in the sparfloxacin group). These data suggest that a once-daily, 3-day regimen of sparfloxacin is effective and generally well tolerated in the treatment of acute uncomplicated urinary tract infections.

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Efficacy and safety of carbapenems versus new antibiotics for treatment of adult patients with complicated urinary tract infections: A systematic review and meta-analysis

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa480 ◽

2020 ◽

Author(s):

Yukiko Ezure ◽

Veronica Rico ◽

David L Paterson ◽

Lisa Hall ◽

Patrick N A Harris ◽

...

Keyword(s):

Systematic Review ◽

Urinary Tract ◽

Clinical Response ◽

Urinary Tract Infections ◽

Clinical Success ◽

Meta Analysis ◽

Significant Risk ◽

Efficacy And Safety ◽

New Antibiotics ◽

Tract Infections

Abstract This systematic review and meta-analysis evaluated the clinical efficacy and safety of carbapenems for the treatment of complicated urinary tract infections (cUTIs) with the comparators being new antibiotics evaluated for this indication. We searched 13 electronical databases for published randomised controlled trials (RCTs) and completed and/or ongoing trials. The search terms were developed by using the PICOS framework. Pooled efficacy estimates of composite cure (clinical success and microbiological eradication) favour the new antibiotic groups, although this is not statistically significant [risk ratio (RR)=0.91; 95% confidence interval (CI); 0.79-1.04]. A pooled estimate examining clinical response alone showed no difference between treatment arms (RR=1.00; 95% CI: 0.96-1.05), however, new antibiotic treatments were superior to carbapenems for microbiological response (RR=0.85; 95% CI: 0.79-0.91). New antibiotic treatments demonstrated a superior microbiological response compared to carbapenems in clinical trials of cUTI, despite an absence of carbapenem resistance. However, it is noteworthy that the clinical response and safety profile of new antibiotics were not different from carbapenems.

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Efficacy and safety of quinolones for the treatment of uncomplicated urinary tract infections in women: a network meta-analysis

10.21203/rs.2.12347/v1 ◽

2019 ◽

Author(s):

Alejandro G Gonzalez-Garay ◽

Liliana Velasco-Hidalgo ◽

Eric Ochoa-Hein ◽

Roberto Rivera-Luna

Keyword(s):

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Adverse Events ◽

Treatment Duration ◽

Meta Analysis ◽

Uncomplicated Urinary Tract Infection ◽

Efficacy And Safety ◽

Menopausal Women ◽

Tract Infections

Abstract Background Uncomplicated urinary tract infection is considered an infection that occurs in healthy individuals who have a normal urinary tract, representing 5% of all annual medical visits. Several quinolones are available as second-line agents for treatment; however, we do not know which is the best antibiotic scheme for urinary tract infection; therefore, we conducted a network meta-analysis to hierarchize each quinolone according to its efficacy and safety. Methods MEDLINE, EMBASE and other databases were subjected to non-language-restricted searches up to 2018 for trials that included women treated with quinolones for uncomplicated urinary tract infection. Bias in the trials was assessed by two reviewers; the Cochrane Collaboration tool was used to analyze clinical and bacteriological remission, relapse, resistance, and adverse events. For direct comparisons, we obtained risk ratios and 95% confidence intervals by applying a fixed events model using Tau2 and Q2 tests to calculate the heterogeneity using trimethoprim/sulfamethoxazole as the common comparator across studies. For the network meta-analysis, we analyzed the indirect comparisons by Bucher's method. The results were summarized in a correlation matrix. Results We included 18 trials with 8765 women. For pre-menopausal women and treatment duration <3 days, norfloxacin and ofloxacin had a 57% of probability for achieving remission but with an 83% frequency of adverse events. For post-menopausal women, ciprofloxacin and ofloxacin were 82% more effective for remission with an 49% frequency of adverse events compared with other types of quinolones. Conclusions Compared with other quinolones, ofloxacin (200 mg) was more effective for remission, although with a high probability of adverse events; however, norfloxacin (400 mg) could be an alternative in treatment, due to it low probability of adverse events; even though additional trials are needed to confirm our findings, especially in treatment duration exceeds 3 days. PROSPERO registration CRD42015025886

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