[Comparison of efficacy and tolerability among 3 quinolones in the treatment of lower urinary tract infections (cinoxacin versus ciprofloxacin and pefloxacin]. / Confronto su efficacia e tollerabilità fra tre chinolonici nel trattamento delle infezioni delle basse vie urinarie (cinoxacina versus ciprofloxacina e pefloxacina).

A clinical trial was carried out in 150 patients with lower urinary tract infections in order to compare the efficacy and tolerability of three quinolone drugs (cinoxacin, ciprofloxacin, pefloxacin). The satisfactory therapeutic efficacy of all three drugs is underlined, as is the excellent tolerability of cinoxacin.

[Therapy of urinary tract infections. Clinical experience comparing norfloxacin to other quinolones]. / Terapia delle infezioni del tratto urinario. Esperienza clinica di confronto tra la norfloxacina ed altri chinolonici.

The paper examines to treatment of 40 cases of urinary infections and compares the efficacy of pipemidic acid, norfloxacin, cinoxacin and ofloxacin. All these compounds demonstrated a good level of therapeutic efficacy, both in terms of management and effectiveness; in particular, norfloxacin and ofloxacin were preferable to the other compounds since they caused fewer side-effects.

[Chronic prophylaxis of urinary tract infections in diabetic patients]. / Profilassi cronica delle infezioni delle vie urinarie in pazienti diabetici.

A mass screening of 600 diabetic revealed 240 (190 female and 50 male) with urinary infections. The comparative antibiotic efficacy (elimination) and tolerability of Cinoxacin and Norfloxacin were assessed in the treatment of these patients. The traditional protocol (2 daily doses for 10-20 days) was supplemented in every case by chronic prophylaxis (a single daily dose for 10 days each month for 6 months) that was designed to prevent recurrences and the development of chronic urinary infections. Cinoxacin was always found to be faster acting in antibacterial terms than Norfloxacin (at 10 days x2 = p less than 0.01; at 2 degrees, 4 degrees, and 6 degrees month x2 = p less than 0.05) providing a more complete and faster remission of the subjective symptoms, as well as being considerably better tolerated a both locally and systematically than Norfloxacin.

[Early antibiotic therapy following urodynamic examination. Results of a randomized, controlled study]. / Terapia antibatterica precoce a seguito di esame urodinamico. Risultati di uno studio randomizzato e controllato.

Forty-three young men from the Italian army underwent urodynamic tests following the diagnosis of enuresis. Of these, 37 were included in an assessment trial to define the rationale for early anti-bacterial therapy following the test. The subjects were subdivided into two groups: one group received 500 mg Cinoxacin b.i.d. for 5 days, and the other group was not treated. The comparison of results revealed a high incidence of irritative disorders in both groups (78.9% of treated subjects and 88.9% of untreated subjects) but the most significant complications were observed in the untreated group (feveret in 27.7% and one case of septic fever). Early anti-bacterial therapy following standard urodynamic tests therefore seems to be a ration tool in urological practice.

[Comparative evaluation of norfloxacin and cinoxacin in the therapy of complicated infections of the urinary tract]. / Valutazione comparativa della norfloxacina e della cinoxacina nella terapia delle infezioni complicate delle vie urinarie.

A randomized clinical study was conducted in order to compare the effectiveness of norfloxacin and cinoxacin in complicated urinary tract infections. Norfloxacin proved effective in 80% of the 40 patients treated, cinoxacin in only 60%.

Infecciones recurrentes del tracto urinario en mujeres: una visión del manejo y tratamiento / Recurrent urinary tract infections in women: a view of the management and treatment

Varios factores mayores han contribuído en mejorar la disponibilidad de técnicas altamente exitosas en el manejo de la infección urinaria recurrente (ITU) en mujeres. Debido a que ITU no puede diagnosticarse solamente por los síntomas, es muy importante una mayor exactitud en las técnicas diagnósticas para establecer si las bacterias en la orina emitida están presentes en la orina vesical. Segundo, es crucial el reconocimiento de que la mayoría de las ITU recurrentes son reinfecciones. Tercero, ha sido observado que la bacteriuria en mujeres es precedida por la colonización de la mucosa introital de la vagina y de la uretra por enterobacterias provenientes de la flora rectal. Un cuarto factor, es el desarrollo de regímenes profilácticos altamente efectivos, incluyendo sulfatoxazol-trimetropin, nitrofurantoina, cinoxacina y cefalexina. En suma, el manejo de pacientes con ITU ha mejorado porque las causas corregibles de la persistencia bacteriana son ahora bién reconocidas y hay una mejor comprensión de los tipos de pacientes con riesgos elevados. Finalmente, nuevos agentes antimicrobianos con farmacoquinética más favorable están disponibles. Una reciente editorial en el Lancet establecía que el manejo de la infección urinaria recurrente (ITU) en mujeres es insatisfactorio. Yo tomo el bando opuesto. En realidad el manejo habitual es tan exitoso que la mayoría de las pacientes mujeres con ITU recurrente puede ser asignada a la supervisión de personal de enfermería para su diagnóstico, tratamiento y seguimiento. ¿Qué observaciones básicas y qué avances de los últimos 25 años han hecho tan satisfactorio el manejo de este problema? Los 8 factores más importantes se discuten en esta presentación

Prevention of recurrent urinary tract infections in premenopausal women by post-coital administration of cinoxacin.

A total of 21 sexually active premenopausal women, prone to recurrent urinary tract infections but who otherwise were healthy, underwent post-coital prophylaxis consisting of bladder voiding and a single 250 mg. tablet of cinoxacin. While 94 urinary tract infections occurred during a mean of 7.5 months before treatment, only 8 occurred during a mean of 12.5 months after prophylaxis. This difference was statistically highly significant. A mean of 106 cinoxacin tablets per patient were administered during post-coital prophylaxis. Cinoxacin represents an additional valuable and effective antibacterial in post-coital prophylaxis of recurrent urinary tract infection in otherwise healthy premenopausal women, although it is slightly less effective than cotrimoxazole or nitrofurantoin. Effective post-coital prophylaxis requires the use of much smaller quantities of antibacterial agents than the daily use of a single tablet and in women with a high incidence of recurrent urinary tract infections it is superior to intermittent self-administered antibacterial therapy.

[Cinoxacin in infections of the lower urinary tract]. / La cinoxacina nelle infezioni delle basse vie urinarie.

The results obtained in 15 patients with infections of the lower urinary tract given 500 mg cinoxacin in two daily doses for 10 days are reported. A positive response was obtained in 13 of the 15 cases. Cinoxacin is easily managed, produces no side effects and can be administered orally, all of which makes it a drug of first choice in the treatment of prophylaxis of lower urinary infections.

Cinoxacin vs trimethoprim--safety and efficacy in the prophylaxis of uncomplicated urinary tract infections.

This study reports the results of long-term (24 weeks) low-dose prophylaxis in 26 young female patients suffering from recurrent uncomplicated urinary tract infection (UTI). The patients were randomized in a double-blind manner to treatment with 100 mg trimethoprim (TMP, 12 patients) or 500 mg cinoxacin (CNO, 14 patients) at bedtime. The duration of prophylaxis in the TMP group was 2016 and in the CNO group 2352 days. Blood chemistry, haematological and urinary parameters were closely monitored during treatment and the latter were followed for a further 4-6 weeks. The prophylactic efficacy of the drugs was equal and significant (p less than 0.05). In the TMP group one recurrence and in the CNO group two recurrences occurred during treatment, two recurrences being observed in each group during the follow-up period of 4-6 weeks. Trimethoprim is well documented and widely used; cinoxacin provides a new alternative for long-term prophylaxis.

[Study of clinical efficacy and safety of long-term cinoxacin therapy of chronic urogenital organ infection].

Thirty-five patients with chronic simple and complicated urogenital organ infections were treated with 400 mg/day Cinoxacin for 60 to 284 days. The effects were judged according to improvements of subjective symptoms, bacteriuria and pyuria before and after the complete administration. Overall clinical efficacy in 35 cases with urogenital organ infections was estimated as excellent: 54%, good: 26%, poor: 17%, and effectiveness rate: 80%. The clinical effectiveness rate in 12 cases of chronic simple urinary tract infection was 100%, and in 14 cases of chronic complicated urinary tract infections was 64%, and in 6 cases of chronic prostatitis the rate of effectiveness was 83%. No recurrence was observed during the treatment. No side-effects or toxicity were seen. Accordingly long-term Cinoxacin therapy seems to be useful in preventing recurrence in chronic infections encountered in the department of urology.

Ciprofloxacin versus cinoxacin in therapy of urinary tract infections. A randomized, double-blind trial.

In a prospective, randomized, double-blind trial, ciprofloxacin (250 mg orally, twice daily) was compared with cinoxacin (500 mg orally, twice daily) in 60 patients with urinary tract infections. Most patients were women with uncomplicated urinary tract infections. Escherichia coli was the most common isolate (36 patients). Clinical and microbiologic cure occurred in 20 of 24 (83 percent) evaluable patients treated with ciprofloxacin, compared with 15 of 21 (71 percent) evaluable patients treated with cinoxacin. Ciprofloxacin was well tolerated and had a low incidence of minor side effects that included Candida vaginitis, headache, and gastrointestinal intolerance. Relapse or failed therapy was not associated with the development of resistance.

Treatment of urinary infections: clinical perspectives.

The present study was carried out with the aim of comparing the microbiological and clinical efficacy of norfloxacin, cinoxacin and aztreonam in urinary tract infections. Patients were tested who had infections of the higher and/or lower urinary tracts associated with complicating factors. The microorganism most frequently isolated in these individuals was Escherichia coli. The assays carried out with the aim of testing the in vitro antibacterial activity (agar diffusion method and minimum inhibitory concentration) on the microorganisms responsible for the infections, as well as the evaluation of clinical efficacy, showed that norfloxacin has a wider antibacterial spectrum of action and inhibitory activity greater than the other two drugs tested.

Estudo clínico e microbiológico de cinoxacin na terapia de infecçöes do trato urinário / Clinical and microbiologic study of cinoxacin in the therapy of urinary tract infections

Trinta e dois pacientes com infecçäo urinária aguda inicial ou recorrente foram tratados com Cinoxacin na dose de 250 mg cada 12 horas por via oral. Vinte e sete pacientes (85%) apresentaram uma resposta clínica e bacteriológica satisfatória. Os pacientes näo apresentaram efeitos colaterais importantes

Pharmacokinetics of cinoxacin in elderly patients following repeated oral administration.

Cinoxacin is an antibacterial drug belonging to the quinolone class used in the treatment of urinary tract infections due to common gram-negative pathogens. Considering the high frequency of urinary tract infections in elderly people where aging represents a physiopathological condition frequently requiring an adjustment of the dosage regimen, the pharmacokinetic behaviour of cinoxacin (500 mg/12 h) in aged patients was investigated to find out if age-dependent differences may be established. The main differences detected were a shift to 4 h of the Tmax and a partly reduced clearance in comparison with data referred to younger people. On the other hand the findings showed that no accumulation occurred. High urinary concentrations of cinoxacin, exceeding the MICs for most urinary tract pathogens were found up to the 12th hour after administration.

[Clinical study of cinoxacin in acute simple cystitis].

Cinoxacin (CINX) was administered twice a day for 7 consecutive days (400 mg X 2/day) to 34 female patients suffering from acute simple cystitis. The overall clinical efficacy was excellent in 15 cases (94%) and moderate in one case (6%) according to the criteria for clinical evaluation by the UTI committee. The efficacy was not determined in 18 cases. Bacteriological examination revealed 11 cases of single infection by E. coli, 2 cases of single infection by P. cepacia and S. epidermidis and one case of single infection by S. sunguis. MIC of E. coli ranged from 3.13 to 6.25 micrograms/ml. MIC of P. cepacia was 3.13 micrograms/ml and MIC of S. epidermidis more than 100 micrograms/ml. All the strains were eradicated with the efficacy of 100%. There was no relapse of acute simple cystitis in 16 cases after 7 days treatment of CINX. No serious side effects were recognized except for slight general fatigue and heart burn in 2 cases. It was thus concluded that CINX is clinically effective and safe for acute simple cystitis caused by E. coli and P. cepacia.