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"\n\nOlder women with acute pyelonephritis can be successfully and  safely treated with oral ciprofloxacin for 7 days, according to a study published online June 21 in The Lancet.\n\nAcute pyelonephritis is a common and potentially serious  infection in many women; however, few trials have assessed optimal treatment,  according to Torsten Sandberg, of the Department of Infectious Diseases at  Sahlgrenska University Hospital in Göteborg, Sweden, and colleagues.\n\nThe authors’ goal was to compare short-term efficacy and  safety of a 7-day versus 14-day regimen. The prospective, randomized,  double-blind, non-inferiority trial with parallel groups was conducted at 21  centers of infectious diseases in Sweden. This study was the first to compare  the same antibiotic against identical daily doses for different durations.\n\nBetween Feb. 1, 2006, and Dec. 31, 2008, the investigators  enrolled 248 women who were 18 years and older and were presumed to have acute  pyelonephritis. The patients were randomly assigned to receive oral treatment  with ciprofloxacin 500 mg twice daily for either 7 days or 14 days. \n\nThe results showed that cure rates were high for both regimens. Of  the 126 patients who received treatment for 7 days, 73 were analyzed and 71  (97%) were cured. Of the 122 patients who received treatment for 14 days, 83  were analyzed and 80 (96%) were cured (difference –0.9%; 90% CI, –6.5 to 4.8; p=0.004; non-inferiority test).\n\nBoth regimens were well-tolerated, and equally effective;  however, the 14-day regimen was associated with more adverse events, the  authors noted. Four (5%) of 86 patients who complied with study criteria and  received 7 days of treatment and six (6%) of 93 assigned to 14 days reported an  adverse event after the first week that may have been associated with the study  drug. In those assigned to 7 days, no patient had mucosal candida infection  after the first week versus five treated for 14 days (p=0.036).\n\n“Our results show that community-acquired acute  pyelonephritis in women can be treated successfully and safely with oral  ciprofloxacin for 7 days and even in older patients and those with a more  severe infection,” the authors wrote. However, they caution that the results  should not be extrapolated to other classes of antibiotics."
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