Cinoxacin, a synthetic organic
acid antibacterial agent, related structurally to nalidixic and
oxolinic acid, has been approved for the treatment of initial and recurrent
urinary tract infections (UTIs) caused by susceptible gram-negative microorganisms. The role of
cinoxacin in the treatment of UTIs, compared with the usual first-line agents, is uncertain at this time. The efficacy of
cinoxacin in the treatment of
pyelonephritis, compared with these proven agents, has been examined in only small numbers of patients, and
cinoxacin is more expensive than these agents.
Cinoxacin may prove valuable in the treatment of
prostatitis and in the prophylaxis of recurrent UTIs; further study in these areas is warranted. In the routine treatment of acute UTIs,
cinoxacin perhaps should be reserved only for those patients with organisms resistant to usual first-line agents or those who fail to respond to
therapy with these agents. In this respect,
cinoxacin may, in the future, replace
nalidixic acid.