A multicenter study of lomefloxacin versus ciprofloxacin in the treatment of complicated urinary tract infections

Integrating fluoroquinolones into the hospital formulary

With the increasing availability of new agents, selection of fluoroquinolones for formulary inclusion can be difficult. Appropriate evaluation of the important characteristics (pharmacokinetic and pharmacodynamic properties, antimicrobial activity, efficacy, tolerability, cost) of these agents should allow selection of the most cost-effective ones. Evidence from in vitro studies and clinical trials indicates differences exist among fluoroquinolones, especially in terms of activity against gram-positive, aerobic organisms. For selected clinical situations, it may be important to choose an agent that is available in both intravenous and oral formulations. Comparative drug costs, as well as costs associated with potential clinical failure and adverse events, should be evaluated carefully. Dosage regimens should be considered, as shorter durations of therapy and less frequent dose administration may lead to reduced labor costs and increased patient compliance, thereby improving effectiveness and economic efficiency.

Lomefloxacin versus ciprofloxacin in the treatment of complicated urinary tract infections: a multicenter study

The efficacy and safety of lomefloxacin 400 mg daily in the treatment of complicated urinary tract infections were confirmed in a randomized multicenter study that enrolled 294 patients from 16 centers in Italy. A total of 155 patients were treated with 400 mg lomefloxacin once daily for 15 days while a total of 139 patients received 500 mg of ciprofloxacin twice daily for 15 days. Eradication of the initial pathogen was observed in 87% of patients treated with lomefloxacin and in 81% of ciprofloxacin-treated patients while clinical success was achieved in 85% of lomefloxacin-treated patients and in 76% of patients treated with ciprofloxacin. The differences in outcome between the two treatment groups were not statistically significant (chi 2 = ns). Both drug regimens were well tolerated and no patients discontinued treatment due to adverse events. In conclusion, once-daily lomefloxacin was as effective as twice-daily ciprofloxacin in the treatment of complicated urinary tract infections.