[Choice of antibiotics in uncomplicated cystitis; application of 'system of objectified judgement analysis' (SOJA) method].
OBJECTIVE
To determine the drug of choice for the treatment of uncomplicated cystitis.


METHODS
Drug selection was performed by means of the so-called 'system of objectified judgement analysis' (SOJA) method by a working group of 11 persons. The following selection criteria were used: pharmacokinetics, interactions, probability of hitting (the probability that the microorganism is sensitive to the antibiotic), development of resistance, specific use in urinary tract infections, efficacy, side effects, dosage-frequency, duration of treatment, cost and documentation. The following drugs were included in the study: amoxicillin (with or without clavulanic acid), nitrofurantoin, sulfamethizole, trimethoprim, co-trimoxazole, ciprofloxacin, norfloxacin, ofloxacin and fosfomycin trometamol.


RESULTS
Fosfomycin and nitrofurantoin slow release showed the highest scores. The main selection criteria that determined the selection of a drug were especially specific use in urinary tract infections, development of resistance, probability of hitting and cost.


CONCLUSIONS
Fosfomycin and nitrofurantoin slow release best fulfill the requirements for drugs in the treatment of uncomplicated cystitis. No comparative studies have been performed with the 3-day treatment of uncomplicated cystitis with nitrofurantoin slow release or with trimethoprim. Fluoroquinolones play no important part in the treatment of uncomplicated cystitis, mainly because of the risk of development of resistance.
Janknegt
R
R
Maasland Ziekenhuis, MB, Sittard.
van den Broek
P J
PJ
Kullberg
B J
BJ
Stobberingh
E
E
D000890:Anti-Infective Agents / Q000627:therapeutic use; D000892:Anti-Infective Agents, Urinary / Q000008:administration & dosage / Q000627:therapeutic use*; D003556:Cystitis / Q000188:drug therapy*; D003692:Delayed-Action Preparations; D024841:Fluoroquinolones; D005578:Fosfomycin / Q000627:therapeutic use; D006801:Humans; D009582:Nitrofurantoin / Q000627:therapeutic use; D014295:Trimethoprim / Q000627:therapeutic use
D000890:Anti-Infective Agents; D000892:Anti-Infective Agents, Urinary; D003692:Delayed-Action Preparations; D024841:Fluoroquinolones; D005578:Fosfomycin; D009582:Nitrofurantoin; D014295:Trimethoprim