A sequential study of intravenous and oral fleroxacin in the treatment of complicated urinary tract infection

Michael Gelfand, B. P. Simmons, R. B. Craft, J. Grogan

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

This study enrolled patients with complicated urinary tract infections (UTIs) in a trial to determine the efficacy and safety of sequential therapy with intravenous fleroxacin (first 3 days) followed by oral fleroxacin, for a total course of 7-14 days, both administered at a dosage of 400 mg once a day. We enrolled 68 patients with complicated UTIs or acute pyelonephritis, 32 of whom were evaluable for bacteriologic and clinical efficacy. The pathogens isolated included Escherichia coli, 15; enterococci, 9; miscellaneous, 15. Intravenous fleroxacin was given for a mean of 3.2 days, followed by oral fleroxacin for a mean of 5.3 days. A total of 27 patients were clinically cured (84%), two improved, and three failed. A total of 26 patients were bacteriologically cured (81%), and six failed (19%). The bacteria that were not eradicated included enterococci, 4; Staphylococcus epidermidis, 1; and Pseudomonas species, 1. One enterococcal isolate became resistant to fleroxacin. Four patients were bacteremic (E. coli, 3; Proteus mirabilis, 1); the pathogen was eradicated in all cases. Two patients developed urinary enterococcal superinfections. A total of 12 patients experienced 16 adverse reactions remotely, possibly, or probably related to fleroxacin (insomnia, 3; dizziness, 2; miscellaneous, 11). One patient had a grand mal seizure after aspirating gastric contents; the seizure was thought to be only remotely related to the study drug. Fleroxacin was discontinued in two patients because of adverse effects (phlebitis at intravenous access site, 1; anxiety and insomnia, 1). Only minor and asymptomatic laboratory abnormalities were observed. All clinical and laboratory abnormalities resolved with discontinuation of the study drug. Fleroxacin is a safe and effective antibiotic for sequential intravenous and oral treatment of acute pyelonephritis and complicated UTIs. Enterococci may be problematic pathogens, as reported with other fluoroquinolones.

Original languageEnglish (US)
JournalAmerican Journal of Medicine
Volume94
Issue number3 SUPPL. A
StatePublished - Jan 1 1993

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Fleroxacin
Urinary Tract Infections
Enterococcus
Therapeutics
Pyelonephritis
Sleep Initiation and Maintenance Disorders
Seizures
Escherichia coli
Phlebitis
Proteus mirabilis
Superinfection
Gastrointestinal Contents
Staphylococcus epidermidis
Fluoroquinolones
Dizziness
Pseudomonas
Pharmaceutical Preparations
Anxiety

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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A sequential study of intravenous and oral fleroxacin in the treatment of complicated urinary tract infection. / Gelfand, Michael; Simmons, B. P.; Craft, R. B.; Grogan, J.

In: American Journal of Medicine, Vol. 94, No. 3 SUPPL. A, 01.01.1993.

Research output: Contribution to journalArticle

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