Types of UTI
- Urethritis - infection of the urethra
- Cystitis - infection of the bladder
- Pyelonephritis - infection of the kidneys
UTIs are more common among women than men, partly because of the short, straight anatomy of the urethra.
Urinary infection symptoms
Symptoms of urinary infection vary according to age, sex, and location of the infection in the tract:
- Frequent urge to urinate (urgency), accompanied by pain or discomfort during urination (dysuria), is the most reliable symptom.
- Cloudy or dark urine
- Strong smelling urine
- Flank pain and fever are the signs of kidney infection.
UTI symptoms in women may include vaginal discharge, especially if the urethra is infected, or if an STD is involved.
Ciprofloxacin and UTIs
Many medical experts support using ciprofloxacin (Cipro) as an alternative and, in some cases, as the preferred first-line antibiotic for UTI treatment. However, others caution that widespread use of fluoroquinolones will promote increased resistance.
Ciprofloxacin is an attractive alternative to TMP-SMX due to its high concentrations in the urogenital tissues, activity against the full range of uropathogens, and well-established clinical efficacy. The study1 found that a three-day regimen of ciprofloxacin was more cost-effective than a three-day regimen of TMP-SMX if the resistance rate to TMP-SMX was >19%.
Ciprofloxacin is useful in treating complicated and uncomplicated cystitis, recurrent UTI, and kidney infection. It is approved by the U.S. FDA for complicated UTIs and pyelonephritis in children.
Ciprofloxacin dosage for UTI
Adults: 250 mg every 12 hours for 7 to 14 days. Complicated infections require 500 mg every 12 hours.
Children 1-17 years of age: 10–20 mg/kg (up to 750 mg) every 12 hours for 10–21 days.
Cystitis (bladder infection) in women:
The usual dosage is 250 mg every 12 hours for 3 days.
Women with recurrences associated with sexual activity may benefit from postcoital prophylaxis - 125 mg single dose of ciprofloxacin taken after sexual intercourse.
How long does it take for Ciprofloxacin to work for UTI?
Ciprofloxacin should be taken for 3-14 days depending on your infection. Marked symptomatic relief in case of bladder infection is expected in 24-48 hours, although milder symptoms may persist for 5-7 days.
Cipro XR rapidly improves symptoms of uncomplicated UTIs in women. In the study2 38% of women reported initial relief of UTI symptoms within 3 hours of taking ciprofloxacin XR, and half of the participants reported significant symptom improvement within 6 hours. Moreover, 87% of women achieved improvement and 22% achieved complete symptom relief within 24 hours.
What if Ciprofloxacin not working?
If ciprofloxacin has failed than urine culture may be required. A urine culture helps identify the specific bacteria causing the infection, and determine which type of antibiotics to use.
To maximize your chances of success in treating UTI you can take cranberry products. Cranberry decreases the incidence of UTIs, especially in women with recurrent UTIs.
Why would UTI not go away after ciprofloxacin?
If the symptoms do not clear up after three days of therapy, most likely you have a ciprofloxacin-resistant infection. Therefore, the second round of the same antibiotic will be useless as well.
Levofloxacin (Levaquin) vs Ciprofloxacin
Efficacy: Levofloxacin (Levaquin) (750 mg once-daily for 7 days) is as effective as ciprofloxacin (500 mg twice-daily for 10 days) in the treatment of UTI.
A study by Peterson compared levofloxacin versus ciprofloxacin in the treatment of complicated urinary tract infections and acute pyelonephritis4. Clinical success was reported to be 79.8% for levofloxacin compared to 77.5% for ciprofloxacin. There was no significant difference in bacterial eradication, with a rate of 88.3% for the levofloxacin group compared to 86.7% for the ciprofloxacin group.
Antibacterial activity: Both fluoroquinolones have excellent activity against the urinary pathogens, including E. coli. Resistance to ciprofloxacin is generally more frequent than to levofloxacin3.
Convenience: Levofloxacin provides shorter and easier once-daily dosage regimen.
- 1. Perfetto EM, Gondek K. Escherichia coli resistance in uncomplicated urinary tract infection: a model for determining when to change first-line empirical antibiotic choice. Manag Care Interface. 2002;15:35–42.
- 2. Klimberg I, Shockey G, Ellison H, Fuller-Jonap F, Colgan R, Song J, Keating K, Cyrus P. Time to symptom relief for uncomplicated urinary tract infection treated with extended-release ciprofloxacin. Curr Med Res Opin. 2005 Aug;21(8):1241-50. PubMed
- 3. Drago L, De Vecchi E, Mombelli B, Nicola L, Valli M, Gismondo MR. Activity of levofloxacin and ciprofloxacin against urinary pathogens. J Antimicrob Chemother. 2001 Jul;48(1):37-45.
- 4. Peterson J, Kaul S, Khashab M, Fisher AC, Kahn JB. A double-blind, randomized comparison of levofloxacin 750 mg once-daily for five days with ciprofloxacin 400/500 mg twice-daily for 10 days for the treatment of complicated urinary tract infections and acute pyelonephritis. Urology. 2008 Jan;71(1):17-22 PubMed
Author: OriginalDrugs Team
Last reviewed: February, 2015
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Fonte: Site do CRMV -SP