Clinical evaluation of norfloxacin versus cotrimoxazole in urinary tract infections

Abstract

Forty patients with urinary tract infections were randomly assigned to receive a ten-day course of oral therapy with either norfloxacin 400 mg twice daily or cotrimoxazole (trimethoprim-sulfamethoxazole) 160/800 mg twice daily. There were 34 cases (19 in the norfloxacin and 15 in the cotrimoxazole group) of evaluable infections due to Escherichia coli (85% of cases), Klebsiella pneumoniae, Enterobacter spp., Proteus vulgaris and Alcaligenes faecalis. All organisms were sensitive to the assigned study drug. Twenty-two strains of Escherichia coli and five other isolates had a norfloxacin MIC50 of 0.03 mg/l and MIC90 of 1.0 mg/l. All patients were cured of the initial infection. Three diabetic patients in the norfloxacin group and another healthy patient in the cotrimoxazole group experienced asymptomatic recurrences due to organisms of the same species which, in the absence of causes of bacterial persistence, were considered to be reinfections. Mild reversible adverse effects of no clinical significance were observed in nine patients in each treatment group. Norfloxacin seems to be as effective and safe as cotrimoxazole in the conventional treatment of uncomplicated urinary tract infection.

Norfloxacin versus trimethoprim-sulfamethoxazole in the therapy of uncomplicated, community-acquired urinary tract infections

“…Cure was achieved in 91% of norfloxacin-treated patients at the 5-to 9-day posttherapy visit, and 88% continued to be asymptomatic and have negative urine cultures 4 to 6 weeks posttherapy. European studies (2,6,7,10,14) showed similar results, but several were either uncontrolled or gave sparse methodology. Clinical side effects (nausea, headache, insomnia) were seen in 23% of the SXT group and 14% of the norfloxacin group.…”

Treatment of genitourinary tract infections with fluoroquinolones: activity in vitro, pharmacokinetics, and clinical efficacy in urinary tract infections and prostatitis

“…For comparative trials, treatment of acute pyelonephritis with norfloxacin as compared with TMP-SMX for 10 days eliminated pathogens from urine in 12 of 14 patients (86%) receiving norfloxacin and in 9 of 10 patients (90%) receiving TMP-SMX (30) and, in a similar study, in 10 of 11 patients (91%) receiving norfloxacin and in 5 of 5 patients receiving TMP-SMX (34) ( Table 4). For data combined from different centers, bacteriologic cure occurred in 30 of 32 patients (94%) treated with norfloxacin and in 29 of 32 patients (91%) treated with TMP-SMX (65).…”

A Cost–Effectiveness Analysis of Treatment Strategies for Acute Uncomplicated Pyelonephritis in Women

“…Mild side effects from TMP-SMX included skin rash, fever, fatigue, mild headache, vaginitis, and epigastric pain. [8][9][10]14 Serious side effects from TMP-SMX included severe headache, severe anaphylaxis reactions, and severe gastrointestinal effects. 8,10 Mild side effects from norfloxacin included fatigue, dizziness, headache, nausea, and epigastric pain.…”

“…8,10 Mild side effects from norfloxacin included fatigue, dizziness, headache, nausea, and epigastric pain. [8][9][10] Serious side effects from norfloxacin included severe gastrointestinal effects and central nervous system effects. 8,[20][21][22] Costs.…”