Survival of elderly bacteriuric subjects following long-term quinolone therapy.
This study aimed to determine whether long-term oral fluoroquinolone administration exerts a significant positive effect on mobility and mortality in elderly subjects with asymptomatic bacteriuria. 132 institutionalized patients were divided into 4 groups: groups A and B were treated with ofloxacin while groups C and D were positive and negative control groups. At 3 months following treatment discontinuation 57%, 53% and 26% of patients in groups A, B and C respectively had negative urine cultures and all subjects were alive. After 3 years, positive cultures were 41.7%, 54.5% and 42.9% respectively for uncatheterized subjects per group vs. 13.3% for group D. In groups A, B, and C 20%, 15% and 29% of survivors respectively had permanent bladder catheters vs. 11.5% of survivors of group D. Survival in groups A, B and C, combined or per group did not differ significantly from group D, although it was shorter. "Pulse" antibiotic administration tended to perform better, in terms of clearing infection and maintaining continence. At 3 years, bacteriuria recurred and the need for bladder catheterization was doubled. Mortality increased independently of treatment. More elderly bacteriuric subjects should be studied to evaluate mobility and mortality issues.
Giamarellou
H
H
Department of Internal Medicine, Athens University School of Medicine, Attikon University General Hospital, Athens, Greece. hgiama@ath.forthnet.gr
Dontas
A S
AS
Petrikkos
G
G
Gnardellis
C
C
Zorbas
P
P
Philippou
P
P
D000368:Aged; D000369:Aged, 80 and over; D000892:Anti-Infective Agents, Urinary / Q000008:administration & dosage*; D001437:Bacteriuria / Q000188:drug therapy* / Q000401:mortality*; D005260:Female; D006115:Greece / Q000453:epidemiology; D006707:Homes for the Aged; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D009735:Nursing Homes; D015242:Ofloxacin / Q000008:administration & dosage*; D016016:Proportional Hazards Models; D020551:Pulse Therapy, Drug
D000892:Anti-Infective Agents, Urinary; D015242:Ofloxacin