Adequacy of the new guidelines on clinical evaluation of drug efficacy in acute uncomplicated cystitis

The adequacy of the newly revised criteria for the evaluation of clinical e fficacy of antimicrobial agents in acute uncomplicated cystitis harmonized to the IDSA/FDA guidelines was studied. Low bacterial counts were significa ntly more frequently found in midstream urine than in catheter urine. Non-u ropathogens were isolated with significantly higher frequency from patients with bacteriuria of 10(3) colony forming units (cfu)/ml than from patients with higher bacterial counts. It is important to exclude non-uropathogens when patients with bacteriuria of 10(3) cfu/ml are included in the study. A lthough the clinical failure rate was very low in patients with eradication of the pathogen, the clinical cure rate was only 67% in patients with micr obiological failure. Microbiological and clinical outcomes coincided in 93% of the patients. However, the coincidence rate was lower when the eradicat ion rate was low. (C) 1999 Elsevier Science B.V. All rights reserved.