Efficacy and Safety of Cefditoren Pivoxil Versus Ciprofloxacin in Acute Uncomplicated Cystitis

The main objective of the study is to comparatively assess the efficacy and tolerability of the drugs under study in the treatment of acute uncomplicated cystitis.

Urinary tract infections (UTI) are one of the most frequent reasons of surgery visits in Primary Care. More than 95 percent of UTIs are monomicrobial, although the microorganisms implied are varied, and the range of effective drugs could be extensive. The species most frequently isolated is Escherichia coli, with prevalence ranking between 85 and 90 percent of documented cases. E. coli has developed resistance to different antibiotics. Cefditoren is situated as a good candidate for the treatment of uncomplicated UTIs due to its spectrum of activity against E. coli. The study has been designed in accordance with the guidelines and recommendations in force to assess the efficacy of cefditoren pivoxil against ciprofloxacin, a drug which despite the increasing rate of resistance in some countries, continues to be a drug of choice for the treatment of uncomplicated UTIs.

• Drug: cefditoren pivoxil
  400 mg, oral, single dose during 3 days
  Other Name: Meiact, Spectracef, Telo
• Drug: Ciprofloxacin
  250 mg, oral, twice a day for 3 days
  Other Name: Ciprofloxacino Mabo

• Experimental: 1
  Cefditoren pivoxil
  Intervention: Drug: cefditoren pivoxil
• Active Comparator: 2
  Ciprofloxacin
  Intervention: Drug: Ciprofloxacin

Inclusion Criteria:

• Non-pregnant adult females (>= 18)
• Clinical signs and symptoms of uncomplicated acute cystitis (dysuria, urgency, frequency, suprapubic pain) with symptoms starting <=72 hours prior the study entry
• Positive pre-treatment clean-catch midstream urine culture (>= 103 CFU/ml) and pyuria (10 leukocytes/mm3 or more than 5 leukocytes/field 40x magnification) within the 48 hours prior to inclusion in the study
• In vitro susceptibility testing of the isolated uropathogen to the drugs under study
• Written informed consent

Exclusion Criteria:

• Males
• Woman who are pregnant, nursing or not using a medically accepted, effective method of birth control
• Three or more episodes of uncomplicated acute infections of the urinary tract during the past 12 months
• Symptoms starting >4 days prior to admission
• Body temperature >= 38.3ºC, back pain, chills or other manifestations suggestive of upper urinary infection
• Evidence of structural or functional alterations of the urinary tract, such as calculi, stenosis, primary renal disease (eg. polycystic renal disease) or neurogenic bladder
• Underlying disease predisposing to complicated urinary tract infections such as diabetes mellitus, immunosuppression, leucopenia, heart insufficiency, liver impairment and neoplastic processes