Acute uncomplicated urinary tract infections (UTIs) are among the most commonly encountered bacterial infections in women, according to background information in the article. Management of these infections has been made more complicated in recent years by increasing antimicrobial resistance, which has led to increased use of alternative antibiotics. There have been no published studies on the efficacy of one such antibiotic, amoxicillin-clavulanate, in the treatment of acute cystitis (inflammation of the urinary bladder) in the current era of high-level amoxicillin resistance.

Thomas M. Hooton, M.D., of the University of Washington and Harborview Medical Center, Seattle, and colleagues conducted a randomized trial that compared 3-day regimens of amoxicillin-clavulanate and ciprofloxacin for treatment of women with acute uncomplicated cystitis and used follow-up to evaluate the women for recurrent infection. Ciprofloxacin is in the fluoroquinolone class of antibiotics, a potent and frequently prescribed group that has shown increasing resistance. The trial included 370 women, aged 18 to 45 years. Subjects were randomly assigned to receive amoxicillin-clavulanate (500 mg/125 mg twice daily) or ciprofloxacin (250 mg twice daily) for 3 days and were followed for 4 months.

The researchers found that clinical cure resolution of the symptoms associated with UTI was observed in 93 (58 percent) of 160 women treated with amoxicillin-clavulanate compared with 124 (77 percent) of 162 women treated with ciprofloxacin. Amoxicillin-clavulanate was not as effective as ciprofloxacin even among women infected with bacterial strains susceptible to amoxicillin-clavulanate (65 [60 percent] of 109 women in the amoxicillin-clavulanate group vs. 114
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Contact: Susan Gregg-Hanson
206-731-4097
JAMA and Archives Journals
22-Feb-2005