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Cipro Beats Augmentin In Treating Urinary Tract Infections

Researcher adds that Cipro shouldn't be first-line treatment, however

TUESDAY, Feb. 22, 2005 (HealthDay News) -- When it comes to antibiotic treatment of simple urinary tract infections, Cipro beats another commonly used medication, Augmentin, new research shows.

The study, published in the Feb. 23 issue of the Journal of the American Medical Association, found that 77 percent of the women treated with a three-day course of Cipro were free of urinary tract infection symptoms after two weeks, compared to 58 percent of the women who took a three-day course of Augmentin.

"While most women got better on either antibiotic, Cipro clearly outperformed Augmentin," said study author Dr. Thomas Hooton, a professor of medicine at the University of Washington and medical director of the HIV/AIDS Clinic at Harborview Medical Center in Seattle.

However, Hooton is quick to point out that the standard first-line treatment is still trimethoprim-sulfamethoxazole, an antibiotic sold under the brand names Bactrim and Septra. However, the current study didn't include a comparison to trimethoprim-sulfamethoxazole.

Uncomplicated urinary tract infections are one of the most common bacterial infections, particularly in women. According to the National Institute of Diabetes and Digestive and Kidney Diseases, urinary tract infections may be responsible for more than 8 million physician visits per year.

Often, these infections don't cause any symptoms early on. Noticeable symptoms include painful urination and a frequent urge to urinate.

Unless you're allergic to sulfa drugs, trimethoprim-sulfamethoxazole is generally the first drug of choice, Hooton said. In some areas of the country, he said, there is concern that bacteria may be growing resistant to trimethoprim-sulfamethoxazole, but "most people will do fine on it, and it's still an excellent first-line antibiotic."

Concern over increasing resistance has led to the use of other antibiotics, such as Augmentin and Cipro, to treat urinary tract infections, according to the study authors.

Augmentin is amoxicillin (a penicillin) combined with clavulanate, while Cipro is from a family of antibiotics known as fluoroquinolones.

For this study, 370 women between the ages of 18 and 45 were randomized to receive either a three-day course of Augmentin or Cipro to treat their urinary tract infections. The researchers reexamined the women two weeks after treatment.

Of the 160 women who received treatment with Augmentin, 93 (58 percent) were considered clinically cured two weeks after treatment, the researchers report. Cipro performed even better, however: Of the 162 women given the drug, 124 (77 percent) were clinically cured.

"This study says that amoxicillin-clavulanate is not a drug that we can turn to reliably to treat simple UTI," said Hooton.

Dr. Marc Siegel, a clinical associate professor of medicine at New York University School of Medicine, said he wasn't surprised that the study found Augmentin wasn't effective in treating urinary tract infections.

"I tend to shy away from Augmentin because a lot of women complain that it gives them yeast infections, and it's a fairly expensive drug. Plus, in treating urinary tract infections, I'm not sure what it has to offer over amoxicillin," Siegel said.

"We should use the simplest antibiotic to solve the problem," said Siegel, who also recommended trimethoprim-sulfamethoxazole as the first line of treatment for women who aren't allergic to the drug.

"Why not use garden-variety Bactrim?" asked Siegel. "It's cheaper and just as effective."

Both Siegel and Hooton also recommended drinking plenty of water and cranberry juice to keep urinary tract infections at bay. Siegel said taking in more fluids at the first sign of an infection might even help clear it up. However, he cautioned, if you have any pain or burning when you urinate, or you have an urgent need to urinate, you should consult your doctor for treatment.

Siegel said individuals prone to urinary tract infections should try to wash the genital area before and after intercourse, and Hooton also recommended urinating after intercourse, to help flush out any bacteria. Also, Hooton noted that spermicides can change vaginal flora and make women more susceptible to urinary tract infections.

More information

To learn more about urinary tract infections, visit the National Institute of Diabetes and Digestive and Kidney Diseases.

SOURCES: Thomas Hooton, M.D., professor, medicine, University of Washington, and director, HIV/AIDS Clinic, Harborview Medical Center, Seattle; Marc Siegel, M.D., clinical associate professor, medicine, New York University School of Medicine, New York City; Feb. 23, 2005, Journal of the American Medical Association
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