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Complicated urinary tract infections treated with extended-release ciprofloxacin with emphasis on Pseudomonas

D Saltzstein1, B Wachs, R Perroncel

  • 1Urology San Antonio Research, TX 78229, USA. beatrice.escamilla@urologysaresearch.com

Journal of Chemotherapy (Florence, Italy)
|January 31, 2008
PubMed

Insights

Extended-release ciprofloxacin effectively treated complicated urinary tract infections, showing high cure rates for Pseudomonas aeruginosa. Treatment failure was linked to ciprofloxacin resistance in P. aeruginosa infections.

Area of Science:

  • Infectious Diseases
  • Pharmacology
  • Urology

Background:

  • Complicated urinary tract infections (cUTIs) pose significant treatment challenges.
  • Pseudomonas aeruginosa is a common pathogen in cUTIs, often associated with treatment failures.
  • Extended-release ciprofloxacin offers a potential therapeutic option for cUTIs.

Purpose of the Study:

  • To evaluate the safety and efficacy of extended-release ciprofloxacin (ciprofloxacin XR) for treating complicated urinary tract infections.
  • To assess the treatment outcomes specifically in patients infected with Pseudomonas aeruginosa.
  • To identify factors predicting P. aeruginosa infection and treatment failure.

Main Methods:

  • Prospective, open-label, multicenter study.
  • 204 patients with cUTIs received ciprofloxacin XR 1000 mg once daily for 7-14 days.
  • Analysis included intention-to-treat (ITT) and clinical/microbiological efficacy populations, with pooled data for P. aeruginosa.

Main Results:

  • Overall bacteriological eradication rate was 82.1% and clinical cure rate was 94.6% in microbiologically valid patients.
  • In the ITT population, bacteriological and clinical cure rates were 42.1% and 55.9%, respectively.
  • Patients with P. aeruginosa infections showed high eradication (100% in microbiologically valid, 58.3% in ITT) and cure rates (100% in microbiologically valid, 75.0% in ITT).
  • Treatment failure correlated with pre-therapy ciprofloxacin resistance in P. aeruginosa isolates.
  • Predictors for P. aeruginosa infection included neurogenic bladder, urinary retention due to benign prostatic hypertrophy, prior UTI, and ischemic heart disease.

Conclusions:

  • Extended-release ciprofloxacin is safe and effective for treating complicated urinary tract infections, including those caused by P. aeruginosa.
  • Ciprofloxacin resistance is a key factor in treatment failure for P. aeruginosa cUTIs.
  • Identifying risk factors for P. aeruginosa can aid in targeted treatment strategies.

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