Complicated and recurrent
urinary tract infections present intriguing clinical management problems. The underlying conditions in patients with complicated
urinary tract infections are anatomical abnormalities of the genitourinary tract,
neurologic disorders resulting in urinary stasis, obstruction, instrumentation, surgery, diabeters mellitus,
renal transplantation, and
renal calculi. In comparative studies the
quinolones have been shown to be effective in 7-14-day treatment courses in complicated
urinary tract infection. Several comparative trials which compare the
fluoroquinolones with
beta-lactam antibiotics or
cotrimoxazole yielded equal or better results for the
quinolones. A cost-saving option is given with some of the
fluoroquinolones that can be administered parenterally and orally which enables the patient to be discharged from the hospital earlier. There are few differences in antimicrobial activity between the newer
quinolones, but differences in the pharmacokinetic properties are evident. The
fluoroquinolones are suitable
therapeutics for complicated
urinary tract infection, because they offer rapid oral absorption, high tissue concentration, broad activity against most Gram-negative and Gram-positive organisms, the possibility of a once-a-day administration, and relatively few side effects.