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- Title
Amoxicillin-Clavulanate vs Ciprofloxacin for the Treatment of Uncomplicated Cystitis in Women: A Randomized Trial.
- Authors
Hooton, Thomas M.; Scholes, Delia; Gupta, Kalpana; Stapleton, Ann E.; Roberts, Pacita L.; Stamm, Walter E.
- Abstract
Context The high prevalence of resistance to trimethoprim-sulfamethoxazole and other antimicrobials among Escherichia coli causing acute cystitis in women has led to increased use of alternative antibiotics. One such antibiotic, amoxicillin-clavulanate, has not been well studied. Objective To compare the efficacy of a 3-day regimen of amoxicillin-clavulanate to that of a 3-day regimen of ciprofloxacin in the treatment of acute cystitis in women. The primary study hypothesis was that the amoxicillin-clavulanate and ciprofloxacin treatment groups would differ in clinical cure. Design, Setting, and Patients Randomized, single-blind treatment trial of 370 women, aged 18 to 45 years, with symptoms of acute uncomplicated cystitis and a urine culture with at least 102 colony-forming units of uropathogens per milliliter from a university student health center or a health maintenance organization. Interventions Women were randomly assigned to receive amoxicillin-clavulanate (500 mg/125 mg twice daily) or ciprofloxacin (250 mg twice daily) for 3 days and were followed up for 4 months. Main Outcome Measures The main outcome measure was clinical cure. Secondary study outcomes of interest were microbiological cure and vaginal E coli colonization at the 2-week follow-up visit. Results Clinical cure was observed in 93 (58%) of 160 women treated with amoxicillin-clavulanate compared with 124 (77%) of 162 women treated with ciprofloxacin (P<.001). Amoxicillin-clavulanate was not as effective as ciprofloxacin even among women infected with strains susceptible to amoxicillin-clavulanate (65 [60%] of 109 women in the amoxicillin-clavulanate group vs 114 [77%] of 149 women in the ciprofloxacin group; P = .004). The difference in clinical cure rates occurred almost entirely within the first 2 weeks after therapy. Microbiological cure at 2 weeks was observed in 118 (76%) of 156 women treated with amoxicillin-clavulanate compared with 153 (95%) of 161 women treated with ci...
- Subjects
CYSTITIS; TREATMENT of escherichia coli diseases; ANTIBIOTICS; AMOXICILLIN; CIPROFLOXACIN; QUINOLONE antibacterial agents; ESCHERICHIA coli diseases; BLADDER diseases; CLINICAL trials; HEALTH outcome assessment; THERAPEUTICS
- Publication
JAMA: Journal of the American Medical Association, 2005, Vol 293, Issue 8, p949
- ISSN
0098-7484
- Publication type
Article
- DOI
10.1001/jama.293.8.949