Use of quinolones in urinary tract infections and prostatitis

The newer quinolones (ciprofloxacin, enoxacin, norfloxacin, ofloxacin, pefloxacin, and fleroxacin) cover the spectrum of gram-positive and gram-negative bacteria causing urinary tract infections, including complicated and nosocomial infections and those caused by multiresistant strains. Even against Chlamydia trachomatis and Ureaplasma urealyticum, some newer quinolones are sufficiently active for successful treatment. These agents reach high and long-lasting concentrations not only in serum and urine, but also in prostatic and seminal fluid and in prostatic tissue. In the treatment of uncomplicated acute cystitis in women, a single dose or short-term treatment has been effective. Comparative studies in complicated urinary tract infections and in geriatric patients with urinary tract infections have demonstrated similar or significantly better results with the newer quinolones than with conventionally used antibiotics (e.g., amoxicillin, trimethoprim-sulfamethoxazole, and pipemidic acid). Only a few noncomparative studies in infections of the male accessory glands (prostatitis, vesiculitis, epididymitis) have been reported so far; the initial results are promising, but further investigations are needed.