title: Treatment of acute uncomplicated cystitis with faropenem for 3 days versus 7 days: multicentre, randomized, open-label, controlled trial.
abstract: OBJECTIVE
  The increasing prevalence of resistant bacteria such as fluoroquinolone-resistant or extended-spectrum β-lactamase-producing strains in pathogens causing acute uncomplicated cystitis has been of concern in Japan. Faropenem sodium is a penem antimicrobial that demonstrates a wide antimicrobial spectrum against both aerobic and anaerobic bacteria. It is stable against a number of β-lactamases.
  
  
  METHODS
  We compared 3 and 7 day administration regimens of faropenem in a multicentre, randomized, open-label, controlled study.
  
  
  RESULTS
  In total, 200 female patients with cystitis were enrolled and randomized into 3 day (N = 97) or 7 day (N = 103) treatment groups. At the first visit, 161 bacterial strains were isolated from 154 participants, and Escherichia coli accounted for 73.9% (119/161) of bacterial strains. At 5-9 days after the completion of treatment, 73 and 81 patients from the 3 day and 7 day groups, respectively, were evaluated by intention-to-treat analysis; the microbiological efficacies were 58.9% eradication (43/73), 20.5% persistence (15/73) and 8.2% replaced (6/73), and 66.7% eradication (54/81), 6.2% persistence (5/81) and 7.4% replaced (6/81), respectively (P = 0.048). The clinical efficacies were 76.7% (56/73) and 80.2% (65/81), respectively (P = 0.695). Adverse events due to faropenem were reported in 9.5% of participants (19/200), and the most common adverse event was diarrhoea.
  
  
  CONCLUSIONS
  The 7 day regimen showed a superior rate of microbiological response. E. coli strains were in general susceptible to faropenem, including fluoroquinolone- and cephalosporin-resistant strains.
authors: Department of Urology, University of Occupational and Environmental Health, Kitakyushu, Japan hamaryo@med.uoeh-u.ac.jp.
authors: Ryoichi
authors: R
authors: Hamasuna
authors: Division of Urology, Department of Surgery Related, Kobe University Graduate School of Medicine, Kobe, Japan.
authors: Kazushi
authors: K
authors: Tanaka
authors: Blood Purification Centre, Kagoshima University Hospital, Kagoshima, Japan.
authors: Hiroshi
authors: H
authors: Hayami
authors: Department of Urology, School of Medicine, Gifu University, Gifu, Japan.
authors: Mitsuru
authors: M
authors: Yasuda
authors: Department of Urology, School of Medicine, Sapporo Medical University, Sapporo, Japan.
authors: Satoshi
authors: S
authors: Takahashi
authors: Department of Urology, Hiroshima University Institute of Biomedical and Health Sciences, Hiroshima, Japan.
authors: Kanao
authors: K
authors: Kobayashi
authors: Department of Urology, Jikei University Katsushika Medical Centre, Tokyo, Japan.
authors: Hiroshi
authors: H
authors: Kiyota
authors: Department of Urology, Hyogo College of Medicine, Nishinomiya, Japan.
authors: Shingo
authors: S
authors: Yamamoto
authors: Division of Integrated Medical Education, Department of Social/Community Medical and Health Science, Kobe University Graduate School of Medicine, Kobe, Japan.
authors: Soichi
authors: S
authors: Arakawa
authors: Department of Urology, University of Occupational and Environmental Health, Kitakyushu, Japan.
authors: Tetsuro
authors: T
authors: Matsumoto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D003556:Cystitis / Q000188:drug therapy* / Q000382:microbiology; D005260:Female; D006090:Gram-Negative Bacteria / Q000187:drug effects / Q000302:isolation & purification; D006094:Gram-Positive Bacteria / Q000187:drug effects / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult; D047090:beta-Lactams / Q000494:pharmacology / Q000627:therapeutic use*
chemical_list: D000900:Anti-Bacterial Agents; D047090:beta-Lactams; C107057:fropenem
keywords: Escherichia coli; RCTs; faropenem sodium; optimal duration