Abstract
In a double-blind, randomized, multicenter study, 463 adult women with symptomatic acute uncomplicated cystitis were treated orally with either a 400-mg single dose of rufloxacin (n = 226) or an 800-mg single dose of pefloxacin (n = 237). Escherichia coli (78%) and Proteus mirabilis (7%) were the most common isolates from 350 patients with significant pretreatment bacteriuria (uropathogens, > or = 10(5) CFU/ml). In the intention-to-treat analysis of patients with significant pretreatment bacteriuria, 343 patients were assessed for bacteriological outcome and 345 were assessed for clinical outcome. The bacteriological cure rate was 88% in the rufloxacin group and 84% in the pefloxacin group (95% confidence interval [CI] for difference in proportions, -4 to 12%), while the clinical resolution rate was 85 and 84%, respectively (95% CI, -8 to 9%). The per-protocol analysis demonstrated that among the 264 assessable patients, the bacteriological cure rate obtained with rufloxacin at 4 weeks of follow-up was comparable to that with pefloxacin (91 versus 85%; 95% CI, -3 to 15%). Among 295 clinically assessable patients, the clinical resolution rate at 4 weeks of follow-up was 89% in the rufloxacin group and 88% in the pefloxacin group (95% CI, -6 to 10%). Potentially drug-related adverse events occurred in 19% of the rufloxacin patients and in 18% of the pefloxacin patients. A single oral dose of 400 mg of rufloxacin is as effective and safe as a single oral dose of 800 mg of pefloxacin for the treatment of acute uncomplicated cystitis in women.
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- Andriole V. T. Use of quinolones in treatment of prostatitis and lower urinary tract infections. Eur J Clin Microbiol Infect Dis. 1991 Apr;10(4):342–350. doi: 10.1007/BF01967009. [DOI] [PubMed] [Google Scholar]
- Barre J., Houin G., Tillement J. P. Dose-dependent pharmacokinetic study of pefloxacin, a new antibacterial agent, in humans. J Pharm Sci. 1984 Oct;73(10):1379–1382. doi: 10.1002/jps.2600731014. [DOI] [PubMed] [Google Scholar]
- Buirma R. J., Horrevorts A. M., Wagenvoort J. H. Incidence of multi-resistant gram-negative isolates in eight Dutch hospitals. The 1990 Dutch Surveillance Study. Scand J Infect Dis Suppl. 1991;78:35–44. [PubMed] [Google Scholar]
- Dornbusch K. Resistance to beta-lactam antibiotics and ciprofloxacin in gram-negative bacilli and staphylococci isolated from blood: a European collaborative study. European Study Group on Antibiotic Resistance. J Antimicrob Chemother. 1990 Aug;26(2):269–278. doi: 10.1093/jac/26.2.269. [DOI] [PubMed] [Google Scholar]
- Hooper D. C., Wolfson J. S. Fluoroquinolone antimicrobial agents. N Engl J Med. 1991 Feb 7;324(6):384–394. doi: 10.1056/NEJM199102073240606. [DOI] [PubMed] [Google Scholar]
- Hooton T. M., Johnson C., Winter C., Kuwamura L., Rogers M. E., Roberts P. L., Stamm W. E. Single-dose and three-day regimens of ofloxacin versus trimethoprim-sulfamethoxazole for acute cystitis in women. Antimicrob Agents Chemother. 1991 Jul;35(7):1479–1483. doi: 10.1128/aac.35.7.1479. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Imbimbo B. P., Broccali G., Cesana M., Crema F., Attardo-Parrinello G. Inter- and intrasubject variabilities in the pharmacokinetics of rufloxacin after single oral administration to healthy volunteers. Antimicrob Agents Chemother. 1991 Feb;35(2):390–393. doi: 10.1128/aac.35.2.390. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Iravani A. Comparative, double-blind, prospective, multicenter trial of temafloxacin versus trimethoprim-sulfamethoxazole in uncomplicated urinary tract infections in women. Antimicrob Agents Chemother. 1991 Sep;35(9):1777–1781. doi: 10.1128/aac.35.9.1777. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Iravani A. Multicenter study of single-dose and multiple-dose fleroxacin versus ciprofloxacin in the treatment of uncomplicated urinary tract infections. Am J Med. 1993 Mar 22;94(3A):89S–96S. [PubMed] [Google Scholar]
- Johnson J. R., Stamm W. E. Diagnosis and treatment of acute urinary tract infections. Infect Dis Clin North Am. 1987 Dec;1(4):773–791. [PubMed] [Google Scholar]
- Jones B. M., Geary I., Lee M. E., Duerden B. I. Activity of pefloxacin and thirteen other antimicrobial agents in vitro against isolates from hospital and genitourinary infections. J Antimicrob Chemother. 1986 Jun;17(6):739–746. doi: 10.1093/jac/17.6.739. [DOI] [PubMed] [Google Scholar]
- Kisicki J. C., Griess R. S., Ott C. L., Cohen G. M., McCormack R. J., Troetel W. M., Imbimbo B. P. Multiple-dose pharmacokinetics and safety of rufloxacin in normal volunteers. Antimicrob Agents Chemother. 1992 Jun;36(6):1296–1301. doi: 10.1128/aac.36.6.1296. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kunin C. M., White L. V., Hua T. H. A reassessment of the importance of "low-count" bacteriuria in young women with acute urinary symptoms. Ann Intern Med. 1993 Sep 15;119(6):454–460. doi: 10.7326/0003-4819-119-6-199309150-00002. [DOI] [PubMed] [Google Scholar]
- Makuch R., Simon R. Sample size requirements for evaluating a conservative therapy. Cancer Treat Rep. 1978 Jul;62(7):1037–1040. [PubMed] [Google Scholar]
- Mattina R., Bonfiglio G., Cocuzza C. E., Gulisano G., Cesana M., Imbimbo B. P. Pharmacokinetics of rufloxacin in healthy volunteers after repeated oral doses. Chemotherapy. 1991;37(6):389–397. doi: 10.1159/000238885. [DOI] [PubMed] [Google Scholar]
- Mattina R., Cocuzza C. E., Cesana M., Bonfiglio G. In vitro activity of a new quinolone, rufloxacin, against nosocomial isolates. Chemotherapy. 1991;37(4):260–269. doi: 10.1159/000238865. [DOI] [PubMed] [Google Scholar]
- Mattina R., Cocuzza C. E., Cesana M. Rufloxacin once daily versus ofloxacin twice daily for treatment of complicated cystitis and upper urinary tract infections. Italian Multicentre UTI Rufloxacin Group. Infection. 1993 Mar-Apr;21(2):106–111. doi: 10.1007/BF01710743. [DOI] [PubMed] [Google Scholar]
- Montay G., Goueffon Y., Roquet F. Absorption, distribution, metabolic fate, and elimination of pefloxacin mesylate in mice, rats, dogs, monkeys, and humans. Antimicrob Agents Chemother. 1984 Apr;25(4):463–472. doi: 10.1128/aac.25.4.463. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Morgan M. G., McKenzie H. Controversies in the laboratory diagnosis of community-acquired urinary tract infection. Eur J Clin Microbiol Infect Dis. 1993 Jul;12(7):491–504. doi: 10.1007/BF01970954. [DOI] [PubMed] [Google Scholar]
- Naber K. G. Use of quinolones in urinary tract infections and prostatitis. Rev Infect Dis. 1989 Jul-Aug;11 (Suppl 5):S1321–S1337. doi: 10.1093/clinids/11.supplement_5.s1321. [DOI] [PubMed] [Google Scholar]
- Nicolle L. E., DuBois J., Martel A. Y., Harding G. K., Shafran S. D., Conly J. M. Treatment of acute uncomplicated urinary tract infections with 3 days of lomefloxacin compared with treatment with 3 days of norfloxacin. Antimicrob Agents Chemother. 1993 Mar;37(3):574–579. doi: 10.1128/aac.37.3.574. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Norrby S. R. Short-term treatment of uncomplicated lower urinary tract infections in women. Rev Infect Dis. 1990 May-Jun;12(3):458–467. doi: 10.1093/clinids/12.3.458. [DOI] [PubMed] [Google Scholar]
- Norrby S. R. Side-effects of quinolones: comparisons between quinolones and other antibiotics. Eur J Clin Microbiol Infect Dis. 1991 Apr;10(4):378–383. doi: 10.1007/BF01967014. [DOI] [PubMed] [Google Scholar]
- Petersen E. E., Wingen F., Fairchild K. L., Halfhide A., Hendrischk A., Links M., Schad M., Scholz H. R., Schürmann N., Siegmann S. Single dose pefloxacin compared with multiple dose co-trimoxazole in cystitis. J Antimicrob Chemother. 1990 Oct;26 (Suppl B):147–152. doi: 10.1093/jac/26.suppl_b.147. [DOI] [PubMed] [Google Scholar]
- Rubin R. H., Shapiro E. D., Andriole V. T., Davis R. J., Stamm W. E. Evaluation of new anti-infective drugs for the treatment of urinary tract infection. Infectious Diseases Society of America and the Food and Drug Administration. Clin Infect Dis. 1992 Nov;15 (Suppl 1):S216–S227. doi: 10.1093/clind/15.supplement_1.s216. [DOI] [PubMed] [Google Scholar]
- Sanders C. C., Sanders W. E., Jr beta-Lactam resistance in gram-negative bacteria: global trends and clinical impact. Clin Infect Dis. 1992 Nov;15(5):824–839. doi: 10.1093/clind/15.5.824. [DOI] [PubMed] [Google Scholar]
- Stamm W. E., Hooton T. M. Management of urinary tract infections in adults. N Engl J Med. 1993 Oct 28;329(18):1328–1334. doi: 10.1056/NEJM199310283291808. [DOI] [PubMed] [Google Scholar]
- Wagenvoort J. H. The value of new antimicrobial agents. Eur J Clin Microbiol Infect Dis. 1993;12 (Suppl 1):S49–S54. doi: 10.1007/BF02389878. [DOI] [PubMed] [Google Scholar]
- Wise R., Andrews J. M., Matthews R., Wolstenholme M. The in-vitro activity of two new quinolones: rufloxacin and MF 961. J Antimicrob Chemother. 1992 Jun;29(6):649–660. doi: 10.1093/jac/29.6.649. [DOI] [PubMed] [Google Scholar]
- Wise R., Johnson J., O'Sullivan N., Andrews J. M., Imbimbo B. P. Pharmacokinetics and tissue penetration of rufloxacin, a long acting quinolone antimicrobial agent. J Antimicrob Chemother. 1991 Dec;28(6):905–909. doi: 10.1093/jac/28.6.905. [DOI] [PubMed] [Google Scholar]
- van Balen F. A., Touw-Otten F. W., de Melker R. A. Single-dose pefloxacin versus five-days treatment with norfloxacin in uncomplicated cystitis in women. J Antimicrob Chemother. 1990 Oct;26 (Suppl B):153–160. doi: 10.1093/jac/26.suppl_b.153. [DOI] [PubMed] [Google Scholar]