alexa A double-blind, randomized comparison of levofloxacin 750 mg once-daily for five days with ciprofloxacin 400 500 mg twice-daily for 10 days for the treatment of complicated urinary tract infections and acute pyelonephritis.


Journal of Antimicrobial Agents

Author(s): Peterson J, Kaul S, Khashab M, Fisher AC, Kahn JB

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Abstract OBJECTIVES: A clinical study was conducted to compare the efficacy and safety of levofloxacin 750 mg once daily for 5 days to ciprofloxacin twice daily for 10 days for the treatment of complicated urinary tract infections (cUTI) or acute pyelonephritis (AP). METHODS: A multicenter, double-blind, randomized, noninferiority study enrolled subjects with AP or cUTI. Subjects received either levofloxacin 750 mg intravenously or orally once daily for 5 days or ciprofloxacin 400 mg intravenously and/or ciprofloxacin 500 mg orally twice daily for 10 days and were evaluated at end of therapy, posttherapy, and poststudy for microbiologic eradication and clinical outcome. RESULTS: A total of 1109 subjects were enrolled; 619 with confirmed diagnosis of AP or cUTI and a study entry uropathogen with a colony count 10(5) CFU/mL or greater and were included in the modified intent-to-treat population. Five hundred six subjects met all criteria for inclusion and were included in the microbiologically evaluable population. At end of therapy, eradication rates in the modified intent-to-treat population were 79.8\% for levofloxacin and 77.5\% for ciprofloxacin-treated subjects (95\% CI, -8.8\% to 4.1\%). In the microbiologically evaluable population, eradication rates were 88.3\% for levofloxacin and 86.7\% for ciprofloxacin-treated subjects (95\% CI, -7.4\% to 4.2\%). Outcomes were comparable for the 2 treatments at posttherapy and poststudy. CONCLUSIONS: This study demonstrates that both drug regimens are safe and effective and that a 5-day course of therapy with levofloxacin, administered at a dose of 750 mg once daily, is noninferior to a 10-day course of therapy with ciprofloxacin for the treatment of AP and cUTI. This article was published in Urology and referenced in Journal of Antimicrobial Agents

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