Ciprofloxacin once versus twice daily in the treatment of complicated urinary tract infections

Ciprofloxacin is considered to be the standard treatment for patients with complicated urinary tract infections (UTI). This multicentre, randomized clinical study was designed to compare a once-daily regimen with 500 mg to the usual twice-daily-regimen with 250 mg orally for 7-20 days. A total of 215 patients with significant bacteriuria (greater than or equal to 10(5) c.f.u./ml for females and greater than or equal to 10(4) c.f.u./ml for males) were included in the study. Eradication of bacteriuria was shown in 84.0% of patients treated with 500 mg q.i.d. and in 90.9% of patients treated with 250 mg b.i.d. Clinical cure or improvement was achieved in 97.3% of those treated with 500 mg q.i.d. versus 95.5% of those treated with 250 mg b.i.d. More superinfections occurred in patients treated with 500 mg q.i.d., mostly caused by gram-positive cocci. The statistical analysis concerning the elimination of bacteriuria using the 95% confidence interval showed a difference of up to 18.4% between the two treatment groups in favour of the 250-mg b.i.d. regimen. Ciprofloxacin was well tolerated with only mild to moderate side-effects (mostly gastrointestinal) in 8% of the patients. When using ciprofloxacin in patients with complicated UTI, its administration in two divided doses can be further recommended as a standard regimen. (C) 1999 Elsevier Science B.V. and International Society of Chemotherapy. All rights reserved.