Lars Bjerrum1, Bente Gahrn-Hansen, Per Grinsted. 1. Research Unit for General Practice, University of Southern Denmark, J.B. Winsløws Vej 9 A, Odense C, Denmark. lbjerrum@health.sdu.dk
Abstract
OBJECTIVE: To investigate whether short-term treatment with pivmecillinam was more effective than sulfamethizole in patients with acute uncomplicated urinary tract infection (UTI). DESIGN: Randomized controlled trial. SETTING: General practice, Denmark. SUBJECTS:Patients (n = 167) with uncomplicated UTI confirmed by positive urine phase-contrast microscopy. MAIN OUTCOME MEASURES: Drug efficacy based on clinical and bacteriological cure. RESULTS:Urinary symptoms disappeared first in patients treated with pivmecillinam, but after five days there was no significant difference in clinical cure rate between the two antibiotics. At the follow-up visit 7-10 days after initiation of treatment, 95.4% of patients treated with pivmecillinam and 92.6% of patients treated with sulfamethizole had no persistent cystitis symptoms (difference 2.8%, CI -4.5%; 10.0%). Bacteriological cure was observed in 68.8% of patients randomized to pivmecillinam and in 77.9% randomized to sulfamethizole (difference -9.2%, CI -24.7%; 6.3%). Some 26.8% of patients randomized to pivmecillinam experienced a new UTI within 6 months after treatment compared with 18.4% of patients randomized to sulfamethizole (difference 8.4%, CI -4.5%;21.4%). No patients developed septicaemia with urinary pathogens within one year after initial treatment. CONCLUSION: Patients treated with a three-day regime of pivmecillinam experienced faster relief of symptoms compared with patients treated with a three-day regime of sulfamethizole. Five days after initiation of treatment there was no significant difference in clinical and bacteriological cure between the two antibiotic regimes.
RCT Entities:
OBJECTIVE: To investigate whether short-term treatment with pivmecillinam was more effective than sulfamethizole in patients with acute uncomplicated urinary tract infection (UTI). DESIGN: Randomized controlled trial. SETTING: General practice, Denmark. SUBJECTS:Patients (n = 167) with uncomplicated UTI confirmed by positive urine phase-contrast microscopy. MAIN OUTCOME MEASURES: Drug efficacy based on clinical and bacteriological cure. RESULTS: Urinary symptoms disappeared first in patients treated with pivmecillinam, but after five days there was no significant difference in clinical cure rate between the two antibiotics. At the follow-up visit 7-10 days after initiation of treatment, 95.4% of patients treated with pivmecillinam and 92.6% of patients treated with sulfamethizole had no persistent cystitis symptoms (difference 2.8%, CI -4.5%; 10.0%). Bacteriological cure was observed in 68.8% of patients randomized to pivmecillinam and in 77.9% randomized to sulfamethizole (difference -9.2%, CI -24.7%; 6.3%). Some 26.8% of patients randomized to pivmecillinam experienced a new UTI within 6 months after treatment compared with 18.4% of patients randomized to sulfamethizole (difference 8.4%, CI -4.5%;21.4%). No patients developed septicaemia with urinary pathogens within one year after initial treatment. CONCLUSION:Patients treated with a three-day regime of pivmecillinam experienced faster relief of symptoms compared with patients treated with a three-day regime of sulfamethizole. Five days after initiation of treatment there was no significant difference in clinical and bacteriological cure between the two antibiotic regimes.
Authors: L E Nicolle; K S Madsen; G O Debeeck; E Blochlinger; N Borrild; J P Bru; C Mckinnon; B O'Doherty; W Spiegel; F A M Van Balen; P Menday Journal: Scand J Infect Dis Date: 2002
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Authors: Filip Jansåker; Sara Thønnings; Frederik Boëtius Hertz; Thomas Kallemose; Jan Værnet; Lars Bjerrum; Thomas Benfield; Niels Frimodt-Møller; Jenny Dahl Knudsen Journal: EClinicalMedicine Date: 2019-07-20
Authors: Ana Garcia-Sangenís; Rosa Morros; Mercedes Aguilar-Sánchez; Laura Medina-Perucha; Alfonso Leiva; Joana Ripoll; Mar Martínez-Pecharromán; Cruz B Bartolomé-Moreno; Rosa Magallon Botaya; Jaime Marín-Cañada; José M Molero; Ana Moragas; Amelia Troncoso; Ramon Monfà; Carl Llor Journal: BMJ Open Date: 2021-11-25 Impact factor: 2.692