Comparison of three-day temafloxacin with seven-day ciprofloxacin treatment of urinary tract infections in women. Fosfomycin trometamol versus norfloxacin in the treatment of uncomplicated lower urinary tract infections of the elderly. A comparison of single-dose versus conventional-dose antibiotic treatment of bacteriuria in elderly women. Optimal duration of antibiotic therapy for uncomplicated urinary tract infection in older women: a double-blind randomized controlled trial. [Acute cystitis in women over 50 years of age. Efficacy of pefloxacin with single dose and norfloxacin for 10 days]. [Urinary tract infection in general practice treated with sulfamethizole in a single dose or for 6 days]. [Treatment of non-complicated acute cystitis in women: lomefloxacin versus pefloxacin]. [Treatment of uncomplicated recurrent cystitis in women: lomefloxacin versus norfloxacin]. 3-day course of ofloxacin versus cefalexin in the treatment of urinary tract infections in postmenopausal women. Acute uncomplicated lower urinary tract infections in general practice: clinical and microbiological cure rates after three- versus five-day treatment with trimethoprim.
Temafloxacin is a new broad-spectrum arylfluoroquinolone antimicrobial with an extended serum half-life.
                In this large, multicenter, double-blind clinical trial, 404 women with acute, uncomplicated urinary tract infections (UTI) were randomized to receive temafloxacin 400 mg once daily for 3 days, or ciprofloxacin 250 mg twice daily for 7 days. Clinical and microbiologic evaluations were repeated at 4 to 5 days after initiation of treatment, at the end of therapy, and at 5 to 9 days posttreatment. One hundred fifteen patients who received temafloxacin and 105 patients who received ciprofloxacin met the eligibility criteria for efficacy evaluation. The predominant urinary pathogens were Escherichia coli, Proteus mirabilis, and coagulase-negative staphylococci. No pretherapy isolate was resistant to either study drug.
                Bacteriologic eradication was observed in 112 (97%) of 115 women treated with temafloxacin and 101 (96%) of 105 women treated with ciprofloxacin. Clinical cure rates at 5 to 9 days posttreatment were 90% (the remaining 10% improved) with temafloxacin and 95% (the remaining 5% improved) with ciprofloxacin. Adverse effects associated with treatment occurred in 24 (12%) women who received temafloxacin and 31 (15%) women who received ciprofloxacin. Headache (2% with temafloxacin and 2% with ciprofloxacin), nausea (3% with temafloxacin and 6% with ciprofloxacin), and somnolence (4% with temafloxacin and 3% with ciprofloxacin) were reported most often. Only three and five patients who were treated with temafloxacin and ciprofloxacin, respectively, discontinued treatment because of adverse effects.
                In this study, a 3-day treatment regimen using a single daily 400-mg dose of temafloxacin was found to be as effective as a 7-day course of ciprofloxacin in women with acute uncomplicated UTI. Ten years of controlled clinical trials supported single-dose therapy efficacy and safety in uncomplicated lower urinary tract infections (UTI). Both local and systematic factors contribute to the high UTI prevalence seen in elderly people. A controlled open randomized study was undertaken to evaluate the clinical efficacy and safety of a new fosfomycin derivative (fosfomycin trometamol) given in a single dose in the treatment of uncomplicated lower UTIs in 60 elderly subjects (mean age 68.4 years). A single 3-gram fosfomycin trometamol dose was compared to a 7-day treatment with norfloxacin 400 mg b.i.d. Midstream urocultures and susceptibility tests were performed to diagnose a UTI and at 3-5 and 25-35 days after discontinuation of therapies. Our results, showing comparable clinical and bacteriological resolution rates in both groups (76.6 and 73.3% in the fosfomycin-trometamol- and norfloxacin-treated subjects, respectively), support the single-dose fosfomycin trometamol efficacy in uncomplicated lower UTIs in an elderly population, suggesting it as a convincing alternative to longer therapeutic regimens. The efficacy of single-dose antibiotic therapy for the treatment of bacteriuria in a group of non-catheterized elderly women was compared with that of conventional 7-10 day courses of antibiotic therapy. Thirty-one women received single-dose treatment and 22 conventional-dose treatment. The cure rates at 1 and 6 weeks for the single-dose treatments were 52% and 38%, respectively, and the cure rates for the conventional-dose treatments at 1 and 6 weeks were 59% and 52%, respectively. It is concluded that there may be a place for the use of single-dose antibiotic therapy for the treatment of selected elderly women with bacteriuria, but larger studies are needed. The optimal duration of antibiotic therapy in older patients with uncomplicated urinary tract infection (UTI) is still a matter of debate. The aim of this randomized controlled double-blind noninferiority trial was to compare the efficacy and safety of 3-day and 7-day courses of oral ciprofloxacin for uncomplicated symptomatic UTI in older women.
                A total of 183 women at least 65 years of age with acute uncomplicated UTI were recruited from ambulatory clinics and hospital acute care units. Patients with pyelonephritis, contraindications to fluoroquinolones, recent use of antibiotics, urinary tract abnormalities and diabetes mellitus were excluded. Women were randomly assigned to receive either ciprofloxacin 250 mg twice daily orally for 3 days followed by placebo for 4 days (the 3-day group, 93 patients) or ciprofloxacin 250 mg twice daily orally for 7 days (the 7-day group, 90 patients). Bacterial eradication, clinical improvement and occurrence of adverse events were determined 2 days after completion of treatment, and occurrence of reinfection or relapse were determined 6 weeks after completion of treatment. Bacterial eradication and relapse were determined by urine culture. Double-blind procedures were maintained throughout data collection.
                The proportion of patients with bacterial eradication at 2 days after treatment was 98% (91/93) in the 3-day group and 93% (83/89) in the 7-day group (p = 0.16). The frequency of adverse events, including drowsiness, headache, nausea or vomiting, and loss of appetite, was significantly lower in the 3-day group.
                These results suggest that a 3-day course of antibiotic therapy is not inferior to a 7-day course for treatment of uncomplicated symptomatic UTI in older women, and that the shorter course is better tolerated. This multicentre, open, randomized trial, involving 482 patients and conducted by private practitioners, compared the effectiveness and safety of a single 800 mg dose of pefloxacin and of a 10 days' course of norfloxacin 400 mg bid. in the treatment of uncomplicated acute cystitis in women aged over 50 years. Clinical effectiveness was evaluated on days 17-19 and 28-32 respectively, and bacteriological effectiveness on days 15-17 and 26-28 respectively. The median time taken for the symptoms to disappear was 2 days with pefloxacin and 3 days with norfloxacin (P < 0.001). Irrespective of the nature of cystitis and the patients' age, no significant difference could be found in eradication of the pathogens. Undesirable side-effects were recorded in 7.8 percent of patients under pefloxacin and in 8.8 percent of those under norfloxacin (P = 0.68); gastrointestinal disorders were predominant. The acceptability of treatment, as judged by the patients themselves, was regarded as excellent by 55 percent of women treated with single dose pefloxacin and by 37.6 percent of those treated with norfloxacin (P = 0.001). nan Compare the acceptability of a 3-day regimen with that of a single-dose regimen of fluoroquinolones for the treatment of lower urinary tract infection in women.
                A multicentric, randomized open trial was conduced in 595 patients by general practitioners to determine acceptability, efficacy and tolerance of lomefloxacine 400 mg in a once a day dose given for three days compared with a once-a-day 800 mg dose of pefloxacin for the treatment of lower urinary tract infection in women.
                The delay to symptom relief was greater than 24 hours in both treatment groups. Symptom relief was observed after treatment onset in only 23% of the patients. Clinical success rate at day 14 was 94.2% for lomefloxacin and 95.7% for pefloxacin. The rates of bacteriological eradication were 90.6% and 92.8% respectively with no significant difference. Adverse events were reported in 27.1% and 33.3% of the patients respectively, digestive disorders (abdominal pain, nausea) and neurosensorial disorders (headache, dizziness) predominated. There was no serious adverse event. The incidence of adverse events related to the treatment according to the investigator was smaller with lomefloxacin (16.1%) than with pefloxacin (23.5%) (p = 0.026).
                Acceptability, assessed at day 14, was not significantly different between the two treatment groups. Lomefloxacin was the only antibiotic currently authorized for use in a three-day regimen for the treatment of lower urinary tract infections. compare the acceptability of 3-day regimen with that of 10-day regimen of fluoroquinolones for the treatment of recurrent uncomplicated lower urinary tract infection in women.
                a multicentric, randomized open trial was conduced in 421 patients by gynecologic and general practitioners to determine acceptability, efficacy and safety of lomefloxacin 400 mg in a once a day dose given for three days compared with norfloxacin 800 mg in twice a day dose given for ten days for the treatment of recurrent uncomplicated lower urinary tract infection in women.
                acceptability, assessed at day 14, was significantly better for lomefloxacin group than norfloxacin group, respectively 57,1 p.100 and 38,0 p.100. Clinical success rate at day 14 was 97,2 p.100 for lomefloxacin and 97,5 p.100 for norfloxacin; at day 30 clinical success rate was respectively 97,6 p.100 and 98,1 p.100 relapse at one year was comparable between two groups. Adverse events were reported respectively in 15,6 p.100 and 16,6 p.100 of the patients, vaginal infections, dermatologic disorders and digestive disorders (abdominal pain, nausea) predominated. There were no serious adverse event.
                the acceptability is better for a 3-day regimen of lomefloxacin than a 10-day regimen of norfloxacin for treatment of recurrent uncomplicated lower urinary tract infection in women for comparable efficacy and safety. nan Epidemiological studies indicate that acute uncomplicated urinary tract infections (UTI) in women can be successfully treated with short treatment regimens. However, the findings from the literature do not match experiences in daily practice.
                A randomised, controlled trial evaluating the microbiological and clinical (self-reported) cure rates of a three-day vs. five-day treatment regimen with trimethoprim for UTI in women.
                No statistically significant difference in bacteriological cure rate was found between the three-day and five-day regimen. One day after the shorter regimen 44% of women considered themselves as 'not-recovered' due to persistence of the symptoms compared with 35% after the five-day treatment (p > 0.05). Three days after therapy these percentages were 30 and 25% respectively.
                The relatively high percentage of persistent symptoms one day after the three-day regimen might be responsible for general practitioners believing that short regimens are not successful. It is therefore advisable that if urine samples are controlled to wait at least three days after finishing treatment.
Short-course treatment (3 to 6 days) could be sufficient for treating uncomplicated UTIs in elderly women, although more studies on specific commonly prescribed antibiotics are needed.