Ciprofloxacin for 2 or 4 weeks in the treatment of febrile urinary tract infection in men: a randomized trial with a 1 year follow-up.
In an open, prospective, single-centre study, 114 men with a presumptive diagnosis of febrile urinary tract infection (UTI) were randomized to oral treatment with ciprofloxacin 500 mg twice daily for 2 or 4 weeks. 72 patients were assessable for efficacy according to the protocol, 65 of whom had prostatic involvement by the infection, as measured by transient increases in serum prostate-specific antigen and prostate volume. All patients responded successfully with resolution of fever and symptoms during treatment. There were no significant differences in short-term bacteriological and clinical cure rates between the 2 treatment regimens [89 vs 97%, 95%, confidence interval (95% CI) for difference in proportions -3 to 19%; and 92 vs 97%, 95% CI -5 to 15%, respectively]. The lower cure rates among those allocated to the 2 week regimen may be explained by a higher frequency of urinary tract abnormalities requiring surgical intervention. After 1 y, 21 patients had experienced recurrences, which comprised asymptomatic bacteriuria (n = 10), symptomatic lower UTI (n = 5) and another episode of febrile UTI (n = 6). The results suggest that a 2 week course of ciprofloxacin may be adequate for febrile UTI in men.
Ulleryd
Peter
P
Department of Infectious Diseases, Sahlgrenska University Hospital, Göteborg, Sweden.
Sandberg
Torsten
T
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D002939:Ciprofloxacin / Q000008:administration & dosage*; D016001:Confidence Intervals; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005334:Fever / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011336:Probability; D011446:Prospective Studies; D012016:Reference Values; D012720:Severity of Illness Index; D016037:Single-Blind Method; D018709:Statistics, Nonparametric; D013997:Time Factors; D016896:Treatment Outcome; D016482:Urinalysis; D014552:Urinary Tract Infections / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*
D002939:Ciprofloxacin