Skip to main content

All Access Subscription

Get unlimited access to our full publication and article library.

Get Access Now

Interested in Group Sales? Learn more

Fluoroquinolones for cystitis

Fluoroquinolones for cystitis

Cefpodoxime is inferior to ciprofloxacin for short-course treatment of acute uncomplicated cystitis in women, according to new study. In a randomized, double-blind trial, 300 women ages 18-55 with uncomplicated cystitis were randomized to ciprofloxacin 250 mg orally twice daily for 3 days or cefpodoxime 100 mg twice daily for 3 days. The overall clinical cure rate with the intent-to-treat approach in which patients lost to follow-up were considered as having a clinical cure was 93% for ciprofloxacin compared to 82% for cefpodoxime. For the intent-to-treat approach in which patients lost to follow-up were considered as not having responded to treatment, the clinical cure rate was 83% for ciprofloxacin compared to 71% for cefpodoxime. The microbiological cure rate was 96% for ciprofloxacin compared with 81% for cefpodoxime. At follow-up, 16% of women in the ciprofloxacin group had vaginal Escherichia coli colonization compared with 40% in the cefpodoxime group. The authors conclude that cefpodoxime did not meet criteria for non-inferiority to ciprofloxacin for treating uncomplicated cystitis in women (JAMA 2012;307:583-589). The study is somewhat disappointing given the increasing rates of fluoroquinolone resistance in the community and the need for effective alternatives.