We treated 52 patients with orally administered ciprofloxacin. In this study of 34 men and 18 women who completed therapy and who could be evaluated, there were 29 patients with nonhematogenous osteomyelitis, 20 patients with skin or soft-tissue infections, and 3 patients with joint infections. During the study, 92 isolates of pathogenic facultative aerobic bacteria, including 37 members of the family Enterobacteriaceae, 30 Staphylococcus aureus isolates, and 21 Pseudomonas aeruginosa isolates, were recovered, and 88 (96%) of the isolates were found to be susceptible to ciprofloxacin. Of the 29 patients with osteomyelitis, 14 have not experienced relapse after a follow-up of at least 1 year. Overall, 61 % of infections were resolved, as judged by both clinical and microbiological criteria, during therapy. One patient developed Streptococcus salivanius sepsis during ciprofloxacin therapy, and one patient developed a rash which required discontinuation of ciprofioxacin. Otherwise, there were no serious reactions or complications.Ciprofloxacin is a quinoline carboxylic acid compound with significant in vitro activity against members of the family Enterobacteriaceae (MIC for 90% of the strains

We evaluated the following five treatment regimens for acute cystitis in nonpregnant women: cefadroxil, 1,000 mg single-dose; cefadroxil, 500 mg twice a day for three days; cefadroxil, 500 mg twice a day for seven days; trimethoprim-sulfamethoxazole (TMP-SMZ), 320-1,600 mg single-dose, and TMP-SMZ, 160-800 mg twice a day for three days. At four weeks after the end of treatment, 25%, 58%, 70%, 65%, and 88% of patients, respectively, remained cured of infection. The results indicated that three-day treatment (1) might improve cure rates (over single-dose), (2) would reduce incidence of relapse (vs. single-dose), and (3) may be as curative as seven-day treatment. The results of the antibody-coated bacteria test did not predict treatment failure or relapse.

Aztreonam (SQ 26,776) is the first parenteral monobactam agent to be used in patient trials. The agent has significant activity in vitro against facultative aerobic gram-negative bacteria but not against gram-positive or anaerobic bacteria. Aztreonam was used for a year to treat 106 hospitalized patients with a total of 131 documented gram-negative infections. Important exclusion criteria included granulocytopenia, hyperbilirubinemia, meningitis, patients less than 13 years of age, pregnancy, and history of anaphylaxis to penicillin. In this study of 35 men and 71 women, there were 67 cases of pyelonephritis (25% bacteremic), 19 of pneumonia (16% bacteremic), 10 of skin or soft-tissue infections, 9 cases of osteomyelitis, and 6 cases of postpartum endometritis. During the study period, 159 facultative aerobic gram-negative bacteria were tested for aztreonam susceptibility, and 144 (91%) were found to be susceptible. Eighty percent of infections were cured by both clinical and microbiological criteria and each of the other 26 infections showed clinical improvement. Eradication of the infecting organism was achieved in 89% of infections without adverse reaction or drug toxicity.

Twenty-three males with the clinical diagnosis of chronic prostatitis were evaluated for a bacterial etiology by the Stamey and Meares method. In addition, 16 patients, regardless of culture results, were placed on either cefadroxil or oral carbenicillin antimicrobial therapy. Culture results identified only four (17%) of 23 patients with bacterial prostatitis: coagulase-negative Staphylococcus (2), Enterobacter agglomerans (1), and Haemophilus parainfluenzae, and coagulase-negative Staphylococcus (1). Four of seven patients who received oral carbenicillin and three of nine patients who received cefadroxil reported symptomatic relief. This study did not identify a common etiology for chronic prostatitis or a consistently effective antimicrobial treatment. Rather, we observed that the etiologic agent in most cases of chronic prostatitis (83%) could not be identified by routine bacteriologic culture. Future research efforts in chronic prostatitis must address not only treatment regimens but expand the search for etiologic agents.

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