Ciprofloxacin for 2 or 4 Weeks in the Treatment of Febrile Urinary Tract Infection in Men: A Randomized Trial with a 1 Year Follow-up

Abstract

In an open, prospective, single-centre study, 114 men with a presumptive diagnosis of febrile urinary tract infection (UTI) were randomized to oral treatment with ciprofloxacin 500 mg twice daily for 2 or 4 weeks. 72 patients were assessable for efficacy according to the protocol, 65 of whom had prostatic involvement by the infection, as measured by transient increases in serum prostate-specific antigen and prostate volume. All patients responded successfully with resolution of fever and symptoms during treatment. There were no significant differences in short-term bacteriological and clinical cure rates between the 2 treatment regimens [89 vs 97%, 95% confidence interval (95% CI) for difference in proportions −3 to 19%; and 92 vs 97%, 95% CI −5 to 15%, respectively]. The lower cure rates among those allocated to the 2 week regimen may be explained by a higher frequency of urinary tract abnormalities requiring surgical intervention. After 1 y, 21 patients had experienced recurrences, which comprised asymptomatic bacteriuria (<emph type="2">n</emph>=10), symptomatic lower UTI (<emph type="2">n</emph>=5) and another episode of febrile UTI (<emph type="2">n</emph>=6). The results suggest that a 2 week course of ciprofloxacin may be adequate for febrile UTI in men.