14-Day Prulifloxacin Treatment of Acute Uncomplicated cystitis in Women with Recurrent Urinary Tract Infections: A Prospective, Open-Label, Pilot Trial With 6-Month Follow-Up

Abstract

Recurrent urinary tract infections (UTI) are very common in otherwise healthy young women, and can have a very negative social and economic impact. In order to evaluate the tolerability and efficacy of a 14-day course of prulifloxacin orally administeredonce daily, 51 young female patients, attending the same STD center between may and June 2007 for symptoms of cystitis, with a history of recurrent UTI and urine culture positive for uropathogens, were enrolled in this prospective study. Microbiological and clinical efficacy was tested over three follow-up visits at 1, 3 and 6 months. Quality of life (QoL) was measured and the impact of prulifloxacin in modifying the Lactobacillus vaginal flora was also evaluated. At baseline, the pathogens most commonly isolated were Enterococcus faecalis (43.2%) and Escherichia coli (27.5%). 41 of the 51 women, (80.3%) had Lactobacillus spp. In vaginal samples at baseline. Microbiological results at follow-up examinations were as follows: after 1 month, 47 patients were recurrence-free and 4 had recurrence; after 3 months, 41 were recurrence free, while 6 reported recurrence; finally, after 6 months, 36 were recur-rence-free and 5 had recurrence. A statistically significant difference was reported between the QoL questionnaire mean scores at baseline (0.63), 1 (0.77), 3 (0.77) and 6months (0.78) after treatment (all p<0.001). The vaginal swab cultures demonstrated that Lactobacillus spp. Flora was maintained in 38 out of the 41 (92.6%) patients who had positive vaginal swab sample at baseline. In conclusion, a 14-day administration of prulifloxacin 600 mg is a safe, well tolerated and effective treatment for the management of UTI in young women.

Keywords:

• Acute uncomplicated cystitis
• recurrent urinary tract infections
• prulifloxacin
• fluoroquinolone
• uropathogens