QUINOLONES IN THE TREATMENT OF COMPLICATED URINARY-TRACT INFECTION

Complicated and recurrent urinary tract infections present intriguing clinical management problems. The underlying conditions in patients wi th complicated urinary tract infections are anatomical abnormalities o f the genitourinary tract, neurologic disorders resulting in urinary s tasis, obstruction, instrumentation, surgery, diabetes mellitus, renal transplantation, and renal caiculi. In comparative studies the quinol ones have been shown to be effective in 7-14-day treatment courses in complicated urinary tract infection. Several comparative trials which compare the fluoroquinolones with B-lactam antibiotics or cotrimoxazol e yielded equal or better results for the quinolones. A cost-saving op tion is given with some of the fluoroquinolones that can be administer ed parenterally and orally which enables the patient to be discharged from the hospital earlier. There are few differences in antimicrobial activity between the newer quinolones, but differences in the pharmaco kinetic properties are evident. The fluoroquinolones are suitable ther apeutics for complicated urinary tract infection, because they offer r apid oral absorption, high tissue concentration, broad activity agains t most Gram-negative and Gram-positive organisms, the possibility of a once-a-day administration, and relatively few side effects.