title: Ciprofloxacin as prophylaxis for urinary tract infection: prospective, randomized, cross-over, placebo controlled study in patients with spinal cord lesion.
abstract: To evaluate the efficacy of low-dose long-term treatment with ciprofloxacin in the prevention of recurrent urinary tract infections in patients with spinal cord lesions and neurogenic bladder dysfunction, a prospective, randomized, cross-over, placebo-controlled study was performed. The study period was 12 months long, including 6 months of treatment with 100 mg. ciprofloxacin at night and 6 months of placebo treatment. The study was completed by 18 men and 3 women, median age 38 years (range 19 to 73 years). Within the last 12 months before inclusion into the study, the patients had between 3 and 14 urinary tract infections (mean 5.8) treated with antimicrobial agents. The number of urinary tract infections treated with antimicrobial agents during 6 months of ciprofloxacin prophylaxis was 5 and during the 6 months of placebo treatment it was 59 (p < 0.00005) [corrected]. Fecal specimens showed supercolonization with ciprofloxacin resistant bacteria (Acinetobacter calcoaceticus) in 1 instance. No severe side effects were observed. Ciprofloxacin at a dose of 100 mg. at night was efficacious in preventing urinary tract infections during 6 months in patients with spinal cord lesions and neurogenic bladder dysfunction. After the controlled study 10 of the 21 patients used ciprofloxacin as prophylaxis for up to 39 months with a marked reduction in the pre-study infection frequency. In 1 patient ciprofloxacin resistant Escherichia coli was subsequently found in the feces.
authors.affiliation: Department of TH, Rigshospitalet, National University Hospital, Copenhagen, Denmark.
authors.forename: F
authors.initials: F
authors.lastname: Biering-Sørensen
authors.forename: N
authors.initials: N
authors.lastname: Høiby
authors.forename: A
authors.initials: A
authors.lastname: Nordenbo
authors.forename: M
authors.initials: M
authors.lastname: Ravnborg
authors.forename: B
authors.initials: B
authors.lastname: Bruun
authors.forename: V
authors.initials: V
authors.lastname: Rahm
mesh_terms: D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D002939:Ciprofloxacin / Q000627:therapeutic use*; D004311:Double-Blind Method; D005243:Feces / Q000382:microbiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013119:Spinal Cord Injuries / Q000097:blood / Q000150:complications*; D001750:Urinary Bladder, Neurogenic / Q000097:blood / Q000209:etiology / Q000517:prevention & control*; D014552:Urinary Tract Infections / Q000097:blood / Q000209:etiology / Q000517:prevention & control*; D014556:Urine / Q000382:microbiology
chemical_list: D002939:Ciprofloxacin; D000410:Alanine Transaminase