Objective: To investigate whether quinolones produce in vivo responses comparable to reported in vitro activity against the spectrum of organisms in uncomplicated urinary tract infection (UTI) in Nigeria.
Design: Equal numbers of patients with urine culture positive UTI were randomized to oral quinolone, perfloxacin 400 mg bd twice a day and ofloxacin 200 mg bd twice a day for five days.
Setting: Out-patient clinics and wards at the University College Hospital, Ibadan.
Subjects: Sixty patients aged sixteen years and above with uncomplicated UTI.
Main outcome measures: Number of isolates, number of patients with clinical and bacteriological cure one week after commencing therapy. Relative effectiveness and side effects of the drugs.
Results: Sixty- four bacterial isolates were obtained with the enterobacteriaceae comprising 86%. Sixty-two (97%) were sensitive to both drugs in vitro. Clinical cure occurred in 57 patients (95%), being 28 (93%) in those taking perfloxacin and 29 (97%) in those taking ofloxacin. Bacteriological cure occurred in 55 patients (92%), being 27 (90%) in those taking perfloxacin and 28 (93%) in those taking ofloxacin. Fifty-nine of the 64 isolates (92%) were eliminated in one week, 30 of 33 (91%) in those taking perfloxacin, and 29 of 31 (94%) in those taking ofloxacin; the difference was insignificant (p = 1.16). The enterobacteriaceae were generally susceptible to both drugs. Side effects were minor and infrequent.
Conclusion: Quinolones were highly active against the common urinary pathogens in these Nigerian patients and can be reliably employed in treatment when culture results are unavailable.