A randomized, double-blind trial of women aged 18 to 55 years with acute uncomplicated cystitis compared ciprofloxacin (n = 150) with cefpodoxime (n = 150).4 Study subjects were randomized to receive either 250 mg of ciprofloxacin orally twice daily for 3 days or 100 mg of cefpodoxime proxetil orally twice daily for 3 days. The primary end point was overall clinical cure (defined as not requiring antimicrobial treatment during follow-up) at the 30-day follow-up visit.
The study demonstrated that the overall clinical cure rate at the 30-day visit with the intent-totreat approach in which patients lost to follow-up were considered as having clinical cure was 93% for ciprofloxacin compared with 82% for cefpodoxime (difference of 11%; 95% CI, 3%-18%). For the intent-to-treat approach, in which patients lost to follow-up were considered as having not responded to treatment, the clinical cure rate was 83% for ciprofloxacin compared with 71% for cefpodoxime (difference of 12%; 95% CI, 3%-21%).
The authors concluded that the use of cefpodoxime as a first-line fluoroquinolone-sparing antimicrobial for acute uncomplicated cystitis cannot be supported by this trial.
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