TUESDAY, Feb. 7 (HealthDay News) -- New antibiotics are needed
to help treat bladder infections, but the drug cefpodoxime, once
thought promising, doesn't appear to be up to the task, a new study
indicates.
Bladder infections, more common in women than men, are usually
treated with a short course of antibiotics. But overuse of mainstay
medications, such as ciprofloxacin, has led to increasing rates of
antibiotic resistance.
"We do have antibiotics to treat bladder infections, but due to increasing rates of resistance, we wanted to see if this other drug [cefpodoxime] was comparable to the gold standard, but it wasn't," said Dr. Thomas Hooton, a professor of clinical medicine at the University of Miami Miller School of Medicine.
"It didn't perform as well as we thought it should to be considered a ciprofloxacin alternative," he said. "This drug should not be considered a first-line treatment of bladder infections in women."
Ciprofloxacin belongs to a class of antibiotics known as
fluoroquinolones. Because of concerns about their continued
effectiveness, efforts are being made to restrict their use and to
find safe and effective alternatives.
Symptoms of bladder infections include frequent or urgent
urination, burning and pain during urination and cloudy or
blood-tinged urine.
The new study, published Feb. 8 in the
Journal of the American Medical Association, included 300 women aged 18 to 55 with uncomplicated bladder infections. They received either 250 milligrams (mg) of ciprofloxacin orally twice a day for three days or 100 mg of cefpodoxime proxetil orally twice a day for three days.
Ciprofloxacin bested cefpodoxime in terms of cure rates at both
the five-day mark and the 30-day mark, the study showed. The study
was funded by grants from the U.S. National Institute of Diabetes
and Digestive and Kidney Diseases.
Currently, the first-line antibiotic treatments for bladder
infections in the United States should include a short course of
trimethoprim-sulfamethoxazole (Bactrim, Cotrim, Septra),
nitrofurantoin or fosfomycin. These drugs should still be chosen
before ciprofloxacin and cefpodoxime, the researchers said.
Dr. Elizabeth Kavaler, a urologist at Lenox Hill Hospital in New
York City, said that most women with uncomplicated bladder
infections can be safely and effectively treated with a short
course of antibiotics.
"They usually do not need any testing or evaluation, and respond very well to the antibiotics that we use," Kavaler said. Women who have had a series of bladder infections may need additional measures, but even then, she said, the antibiotic in the new study would not have been on her radar.
More information
Learn more about the signs and symptoms of
bladder infections at the U.S. National Institutes
of Health.