Ofloxacin for the treatment of urinary tract infections and biofilms in spinal cord injury

Forty two paraplegic and quadriplegic hospitalized spinal cord injured pati ents with urinary tract infections (UTI) were included in a double blind. r andomized treatment study comparing 7 days ofloxacin (300 mg bd) with trime thoprim-sulphamethoxazole (TMPSMX; 160-800 mg bd) or an alternative: chosen because of resistance to TMPSMX. The 4-day clinical cure ratel defined as an asymptomatic patient with sterile urine, was 90% (19/21) with ofloxacin, significantly greater than 48% (10/21) for the comparison group (P = 0.003 ) and the rate at end of therapy was 90% (19/21) with ofloxacin, against 57 % (12/21) (P = 0.015). Bacterial biofilms were detected on bladder epitheli al cells in 39/41 (95%) patients. The biofilm score fell significantly foll owing ofloxacin therapy (P < 0.001) or alternative therapy (P < 0.001). Ofl oxacin treatment led to significantly more biofilm eradication than the oth er antibiotic group on day 4 (62 vs. 24%) (P = 0.005) and day 7 (67 vs. 35% ) (P = 0.014). The study showed that ofloxacin was better than TMPSMX: and alternatives at relieving clinical infection and eradicating bladder cell b iofilms. (C) 2000 Elsevier Science B.V, and International Society of Chemot herapy. All rights reserved.