Korean J Urol.  2007 Jan;48(1):35-39. 10.4111/kju.2007.48.1.35.

The Efficacy and Safety of a Once-daily Extended-release Ciprofloxacin Tablet for the Empirical Treatment of Symptomatic Uncomplicated Cystitis in Korean Women

Affiliations
  • 1Department of Urology, Inje University College of Medicine, Busan, Korea. urokang@lycos.co.kr

Abstract

PURPOSE: To compare the efficacy and safety of a 3-day regimen of extended-release ciprofloxacin (ciprofloxacin ER), 500mg qd, with trimethoprim-sulfamethoxazole (TMP/SMX), 800mg/160mg bid, for the empirical treatment of acute uncomplicated cystitis in Korean women.
MATERIALS AND METHODS
A randomized, single-blind treatment trial of 75 women with acute uncomplicated cystitis was conducted. The women were prescribed ciprofloxacin ER, 500mg qd, or TMP/SMX, 800mg/160 mg, bid for 3 days. The patients were assessed in terms of the clinical and microbiological outcome and safety 7 days after treatment.
RESULTS
Sixty-five women were eligible for the analyses (32 ciprofloxacin ER and 33 TMP/SMX). The most prevalent causative organism was Escherichia coli (76.9%), followed by Proteus (6.2%) and coagulase-negative Staphylococcus (6.2%). The rates of in vitro susceptibility to ciprofloxacin and TMP/SMX were 86.2 (56/65) and 73.4% (48/65), respectively. The clinical cure rates with ciprofloxacin ER and TMP/SMX were 87.5 and 78.8%, respectively. Microbiological cures at 7 days were observed in 25 of the 32 (78.1%) with ciprofloxacin ER and 18 of the 33 (54.5%) with TMP/SMX. The mean interval to improvement in the clinical symptoms after ciprofloxacin and TMP/SMX medications were 1.93+/-0.55 and 2.92+/-0.48 days, respectively. Adverse events with ciprofloxacin and TMP/SMX occurred in 28.1 and 15.5%, respectively, but both treatments were well tolerated.
CONCLUSIONS
Although some organisms were resistant (13.8%) to ciprofloxacin, ciprofloxacin ER was superior to TMP/SMX in terms of the clinical and microbiological cure rates and the mean interval to improvement in the clinical symptoms. The high prevalence of resistance and low microbiological cure rates for TMP/SMX suggest that this drug does not provide an adequate initial therapy, while once-daily ciprofloxacin ER was safe and effective in the empirical treatment of symptomatic uncomplicated cystitis.

Keyword

Cystitis; Woman; Ciprofloxacin

MeSH Terms

Ciprofloxacin*
Cystitis*
Escherichia coli
Female
Humans
Prevalence
Proteus
Staphylococcus
Trimethoprim-Sulfamethoxazole Combination
Ciprofloxacin
Trimethoprim-Sulfamethoxazole Combination

Cited by  1 articles

Virulence Characteristics and Phylogenetic Background of Ciprofloxacin Resistant Escherichia coli in the Urine Samples from Korean Women with Acute Uncomplicated Cystitis
Chul Sung Kim, Min Eui Kim, Yong-Hyun Cho, In Rae Cho, Gilho Lee
J Korean Med Sci. 2010;25(4):602-607.    doi: 10.3346/jkms.2010.25.4.602.


Reference

1. Stamm WE, Hooton TM. Management of urinary tract infections in adults. N Engl J Med. 1993. 329:1328–1334.
2. Warren JW, Abrutyn E, Hebel JR, Johnson JR, Schaeffer AJ, Stamm WE. Guidlines for antimicrobial treatment of uncomplicated acute bacterial cystitis and acute pyelonephritis in women. Infections Diseases Society of America (IDSA). Clin Infect Dis. 1999. 29:745–758.
3. Gupta K, Scholes D, Stamm WE. Increasing prevalence of antimicrobial resistance among uropathogens causing acute uncomplicated cystitis in women. JAMA. 2000. 281:736–738.
4. Lee SJ, Cho YH, Kim BW, Lee JG, Jung SI, Lee SD, et al. A multicenter study of antimicrobial susceptibility of uropathogens causing acute uncomplicated cystitis in woman. Korean J Urol. 2003. 44:697–701.
5. Talan DA. Ciprofloxacin extended-release and urinary tract infection. 2003. New Jersey: Science Press;5–8.
6. Talan DA, Naber KG, Palou J, Elkharrat D. Extended-release ciprofloxacin (Cipro XR) for treatment of urinary tract infections. Int J Antimicrob Agents. 2004. 23:S54–S66.
7. Stamm WE. Scientific and clinical challenges in the management of urinary tract infections. Am J Med. 2002. 113:Suppl 1A. 1S–4S.
8. Henry DC Jr, Bettis RB, Riffer E, Haverstock DC, Kowalsky SF, Manning K, et al. Comparison of once-daily extended-release ciprofloxacin and conventional twice-daily ciprofloxacin for the treatment of uncomplicated urinary tract infection in women. Clin Ther. 2002. 24:2088–2104.
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