33608
document
Short-course nitrofurantoin for the treatment of acute uncomplicated cystitis in women . BACKGROUND There is a paucity of data on the efficacy of nitrofurantoin for the treatment of acute uncomplicated cystitis in regimens shorter than 7 days . Evidence-based use of this drug is increasingly important as trimethoprim-sulfamethoxazole resistance among uropathogens increases . METHODS To assess the efficacy of nitrofurantoin vs trimethoprim-sulfamethoxazole , 338 women aged 18 to 45 years with acute uncomplicated cystitis were randomized to open-label treatment with either trimethoprim-sulfamethoxazole , 1 double-strength tablet twice daily for 3 days , or nitrofurantoin , 100 mg twice daily for 5 days . Clinical cure 30 days after therapy was the main outcome measure . Secondary outcomes included clinical and microbiological cure rates 5 to 9 days after therapy and , for trimethoprim-sulfamethoxazole-treated women , clinical cure stratified by the trimethoprim-sulfamethoxazole susceptibility of the uropathogen . RESULTS Clinical cure was achieved in 79 % of the trimethoprim-sulfamethoxazole group and in 84 % of the nitrofurantoin group , for a difference of -5 % ( 95 % confidence interval , -13 % to 4 % ) . Clinical and microbiological cure rates at the first follow-up visit were also equivalent between the 2 groups . In the trimethoprim-sulfamethoxazole arm , 7 of 17 women ( 41 % ) with a trimethoprim-sulfamethoxazole-nonsusceptible isolate had a clinical cure compared with 84 % of women with a trimethoprim-sulfamethoxazole-susceptible isolate ( P < .001 ) . CONCLUSION A 5-day course of nitrofurantoin is equivalent clinically and microbiologically to a 3-day course of trimethoprim-sulfamethoxazole and should be considered an effective fluoroquinolone-sparing alternative for the treatment of acute cystitis in women .
33609
Intervention_Pharmacological
nitrofurantoin
33610
Intervention_Pharmacological
nitrofurantoin
33611
Intervention_Pharmacological
trimethoprim-sulfamethoxazole
33612
Intervention_Pharmacological
nitrofurantoin
33613
Intervention_Pharmacological
trimethoprim-sulfamethoxazole
33614
Intervention_Pharmacological
trimethoprim-sulfamethoxazole
33615
Intervention_Pharmacological
nitrofurantoin
33616
Intervention_Pharmacological
trimethoprim-sulfamethoxazole-treated
33617
Intervention_Pharmacological
trimethoprim-sulfamethoxazole
33618
Intervention_Pharmacological
trimethoprim-sulfamethoxazole
33619
Outcome_Physical
Clinical cure 30 days after therapy
33620
Outcome_Physical
clinical and microbiological cure rates
33621
Outcome_Physical
clinical cure
33622
Outcome_Physical
Clinical cure
33623
Outcome_Physical
Clinical and microbiological cure rates
33624
Participant_Condition
acute uncomplicated cystitis
33625
Participant_Sex
women
33626
Participant_Sample-size
338
33627
Participant_Sex
women
33628
Participant_Age
aged 18 to 45 years
33629
Participant_Condition
acute uncomplicated cystitis
33630
Participant_Condition
acute cystitis
33631
Participant_Sex
women