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Oral ciprofloxacin in resistant urinary tract infections
Abstract:
Thirty-two patients (18 men and 14 women), who ranged in age from 28 to 91 years (mean, 71.2 years), with urinary tract infections caused by Pseudomonas species or other organisms resistant to trimethoprim-sulfamethoxazole were treated with 500 mg of orally administered ciprofloxacin every 12 hours. Thirty patients completed at least five days of therapy and were evaluated for efficacy. Of these, the treatment of 28 (93 percent) patients was considered successful, with urine cultures yielding negative results five to nine days after cessation of therapy. Three of these patients were found to be reinfected with their primary pathogens when culture specimens were obtained again three to four weeks later. The two patients who received treatment that was classified as having failed had urine cultures that persistently grew Pseudomonas aeruginosa. Superinfections occurred in eight patients, four with diabetes and four with underlying central nervous system disease. Adverse reactions required discontinuation of therapy in two patients. Although the rates of reinfection and superinfection were somewhat high, these patients had a high frequency of underlying diseases that predisposed them to recurrent or difficult-to-treat infections. Despite these shortcomings, ciprofloxacin is a welcome addition to the oral antibiotic regimen for the treatment of antibiotic-resistant urinary infections.
Insights
Ciprofloxacin effectively treated antibiotic-resistant urinary tract infections in 93% of patients. This oral antibiotic is a valuable option for difficult-to-treat infections, despite some reinfection and superinfection occurrences.
Area of Science:
- Infectious Diseases
- Pharmacology
- Urology
Background:
- Antibiotic resistance in urinary tract infections (UTIs) poses a significant clinical challenge.
- Trimethoprim-sulfamethoxazole is often ineffective against resistant pathogens like Pseudomonas species.
Purpose of the Study:
- To evaluate the efficacy and safety of oral ciprofloxacin for treating UTIs caused by antibiotic-resistant organisms.
- To assess the clinical outcomes in patients with recurrent or difficult-to-treat UTIs.
Main Methods:
- A study involving 32 patients with UTIs resistant to trimethoprim-sulfamethoxazole.
- Patients received oral ciprofloxacin 500 mg every 12 hours for at least five days.
- Efficacy was assessed by urine culture results post-therapy; adverse events were recorded.
Main Results:
- Of 30 evaluable patients, 93% (28/30) showed successful treatment, indicated by negative urine cultures 5-9 days after therapy.
- Two patients (7%) had persistent Pseudomonas aeruginosa growth, indicating treatment failure.
- Eight patients experienced superinfections, and two discontinued therapy due to adverse reactions.
Conclusions:
- Oral ciprofloxacin demonstrated high efficacy in treating antibiotic-resistant UTIs, including those caused by Pseudomonas species.
- Despite notable rates of reinfection and superinfection, likely due to underlying comorbidities, ciprofloxacin is a valuable therapeutic option.
- Ciprofloxacin represents a significant addition to the oral antibiotic choices for managing challenging UTIs.
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