Quinolones in the treatment of uncomplicated urinary tract infections

In comparative clinical studies the quinolones have been shown to be effective in a short-course (3-5 days) or a single dose therapy in uncomplicated urinary tract infections. Comparative clinical trials of single dose therapy with the fluoroquinolones and trimethoprim or co-trimoxazole (trimethoprim/ sulfamethoxazole) for acute bacterial cystitis have shown equivalent efficacy. Studies on the use of quinolones for the treatment of uncomplicated acute pyelonephritis have also been reviewed. The results from several comparative trials which compared the fluoroquinolones with netilmicin, co-trimoxazole, cefadroxil, or ceftazidime have been comparable. Some of the fluoroquinolones can be administered in parenteral and oral forms enabling the patient to be discharged from hospital earlier, a more cost-effective option. The fluoroquinolones, in particular norfloxacin, have also been shown to be effective as prophylactic agents for patients with recurrent symptomatic urinary tract infections. The optimal dosage and length of prophylactic treatment have not yet been clearly defined.