5-, 10-day regimens show similar efficacy in acute UTIs, pyelonephritis

A once-daily, 5-day course of levofloxacin (Levaquin) is equally effective as standard 10-day, twice-daily treatment with ciprofloxacin (Cipro) in the treatment of complicated urinary tract infections and acute pyelonephritis, according to study data reported at the AUA annual meeting.

"A short course of five, once-daily doses of Levaquin, 750 mg, is as effective as 10 twice-daily doses of ciprofloxacin in treating complicated urinary tract infections and acute pyelonephritis," said Norman R. Rosenthal, MD, of Ortho-McNeil, Inc., whose researchers presented the data here. "These findings will be important to the health care professionals that treat patients with these conditions."

The multicenter, double-blind, randomized study of 1,109 patients with either complicated UTIs or acute pyelonephritis was designed to assess the efficacy and safety of levofloxacin, 750 mg once daily for 5 days, versus ciprofloxacin, 400/500 mg twice daily for 10 days. Study endpoints included microbiologic eradication, clinical response, and safety.

The microbiologic eradication rates in the acute pyelonephritis and complicated UTI patients were comparable in both treatment groups (79.8% and 77.8% for levofloxacin and ciprofloxacin, respectively) at end of therapy (study day 11 ±-1), researchers reported. This finding held true for patients with various other complicating factors, such as bacteremia. Resolution of or improvement in urinary symptoms was also similar in both groups.

The most commonly reported adverse events with both treatments were nausea, headache, and diarrhea, but no significant differences in the frequency of these events were observed between the two groups.