Long-term follow up of acute uncomplicated cystitis in females

• Published in: Japanese Journal of Chemotherapy Vol. 44; no. 12; pp. 896 - 902
• Main Authors: Kojima, Hironori, Ishida, Yoshio, Yoshida, Masahiko, Fukushima, Syuji, Saito, Isao, Kawamura, Takeshi, Hirose, Tomonobu, Kawada, Yukimichi, Moriyama, Masatoshi, Kawasaki, Chitose
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society of Chemotherapy 1996; 公益社団法人 日本化学療法学会
• Subjects: levofloxacin; UTI薬効評価基準; 急性単純性膀胱炎
• ISSN: 1340-7007; 1884-5886
• DOI: 10.11250/chemotherapy1995.44.896

Therapeutic effects of levofloxacin (LVFX) on acute uncomplicated cystitis in females werecomparatively examined on the basis of the Japanese evaluation criteria for the effect of drugs on urinary tract infection (UTI) and general guidelines for the evaluation of new anti-infective drugs for the treatment of UTI established by the Infectious Diseases Society of America. A 100 or 200 mg/day dose of LVFX was administered for 3-5 days to a total of 158 cases in which a diagnosis of acute uncomplicated cystitis, accompanying pyuria with 5 cells/hpf or more and bacteriuria with 103CFU/ml or more, had been made in the facilities participating in this study from September 1994 to March 1995. Clinical effects of LVFX were evaluated immediately, one week and four weeks after completion of drug administration. The results of overall clinical efficacy immediately after completion of administration were as follows: “excellent” in 71.6% of all cases (106/148 cases); “moderate” in 27.7%(41/148); and “failure” in 0.7%(1/148). The effects revealed no significant differences between either daily doses or the numbers of dosing days. The results of microbiological eradication rate/clinical cure rate, one and four weeks after the completion of administration were 93.9%(77/82)/88.1%(74/84) and 92.9%(52/56)/88.5%(54/61), respectively, indicating a high clinical effect. These rates were analyzed according to the number of dosing days, and the following results were obtained, respectively: 89.1%(41/46)/80.4%(37/46) and 90.0%(27/30)/81.3%(26/32) in the 3-day group; 100%(13/13)/100%(13/13) and 88.9%(8/9)/90%(9/10) in the 4-day group; and 100%(23/23)/96.0%(24/25) and 100%(17/17)/100%(19/19) in the 5-day group. Thus, the cure rates tended to be higher in the 5-day administration group, though there were no statistically significant differences. In addition, when the cases were classified into an “excellent” group and “moderate” group immediately after completion of administration to compare the cure rates in the subsequent weeks between the group, the results still showed no significant differences. In some studies, new quinolones even with single dose therapy have shown remarkably high cure rates against acute uncomplicated cystitis. Five-day administration of the drug may, however, be appropriate considering the long-term results (until the 4th week after treatment) obtained in this study. Further acquisition of data from cases and future discussion from the viewpoint of cost-effectiveness are thus considered to be necessary.