title: Ofloxacin for the treatment of urinary tract infections and biofilms in spinal cord injury.
abstract: Forty two paraplegic and quadriplegic hospitalized spinal cord injured patients with urinary tract infections (UTI) were included in a double blind, randomized treatment study comparing 7 days ofloxacin (300 mg bd) with trimethoprim-sulphamethoxazole (TMPSMX; 160-800 mg bd) or an alternative, chosen because of resistance to TMPSMX. The 4-day clinical cure rate, defined as an asymptomatic patient with sterile urine, was 90% (19/21) with ofloxacin, significantly greater than 48% (10/21) for the comparison group (P=0.003) and the rate at end of therapy was 90% (19/21) with ofloxacin, against 57% (12/21) (P=0.015). Bacterial biofilms were detected on bladder epithelial cells in 39/41 (95%) patients. The biofilm score fell significantly following ofloxacin therapy (P < 0.001) or alternative therapy (P < 0.001). Ofloxacin treatment led to significantly more biofilm eradication than the other antibiotic group on day 4 (62 vs. 24%) (P=0.005) and day 7 (67 vs. 35%) (P=0.014). The study showed that ofloxacin was better than TMPSMX and alternatives at relieving clinical infection and eradicating bladder cell biofilms.
authors.affiliation: Lawson Research Institute, London, Ont., Canada. gregor@julian.uwo.ca
authors.forename: G
authors.initials: G
authors.lastname: Reid
authors.forename: P
authors.initials: P
authors.lastname: Potter
authors.forename: G
authors.initials: G
authors.lastname: Delaney
authors.forename: J
authors.initials: J
authors.lastname: Hsieh
authors.forename: S
authors.initials: S
authors.lastname: Nicosia
authors.forename: K
authors.initials: K
authors.lastname: Hayes
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D000892:Anti-Infective Agents, Urinary / Q000008:administration & dosage / Q000494:pharmacology*; D018441:Biofilms / Q000187:drug effects*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015242:Ofloxacin / Q000008:administration & dosage / Q000494:pharmacology*; D013119:Spinal Cord Injuries / Q000150:complications* / Q000188:drug therapy / Q000652:urine; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000494:pharmacology; D001743:Urinary Bladder / Q000382:microbiology; D014552:Urinary Tract Infections / Q000188:drug therapy* / Q000382:microbiology / Q000652:urine; D019459:Urothelium / Q000382:microbiology
chemical_list: D000892:Anti-Infective Agents, Urinary; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D015242:Ofloxacin