***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The efficacy of oral ciprofloxacin was compared with that of parenteral aminoglycoside for therapy of complicated urinary tract infection in a prospect i ve r and omized trial . The setting was a chronic-care Veterans Administration facility in which long-term bladder catheterization and resistant bacteria were common . Sixty-five consecutive patients were stratified for presence and type of bladder catheter , the presence of Providencia and Pseudomonas aeruginosa organisms versus other urinary pathogens , and renal dysfunction . A pharmacokinetic study of ciprofloxacin concentrations in serum and urine was performed with selected patients . Urinary catheters were present in 94 % . All patients were symptomatic , and 58.5 % had fever . Ciprofloxacin , 500 mg every 12 h orally , was compared with parenteral aminoglycoside for 7 to 10 days . Clinical response , defined by resolution of symptoms and fever at 5 to 9 days posttherapy ( short-term ) and 28 to 30 days posttherapy ( long-term ) , was essentially identical for both treatment groups . Bacteriologic response , defined by sterile urine cultures , showed that ciprofloxacin was significantly more efficacious ( P = 0.0005 ) than aminoglycoside at 5 to 9 days posttherapy . However , by 28 to 30 days , the response rate was essentially identical . Emergence of resistance to the study antibiotic was seen in 62 and 70 % of those who did not show a bacteriological response and were receiving ciprofloxacin and aminoglycosides , respectively . Concentrations of ciprofloxacin and aminoglycoside in the urine substantially exceeded the MIC for the urinary pathogens isolated , although these concentrations did not correlate with short-term bacteriologic response for either antibiotic . Ciprofloxacin was efficacious in complicated urinary tract infection  compared with the current st and ard of parenteral aminoglycoside among catheterized patients with relatively resistant bacteria Abstract The aim of this trial was to compare the efficacy and safety of extended-release ciprofloxacin ( CIPRO XR ) versus the immediate-release formulation ( CIPRO IR ) in the treatment of complicated urinary tract infections ( UTIs ) . 212 patients were r and omized to CIPRO XR 1,000 mg tablet once daily or CIPROXIN IR 500 mg tablet twice daily . Treatment efficacy was evaluated by bacteriological outcome . Safety was measured by recording adverse events . The rate of bacteriological eradication was 83 % in the CIPRO XR group and 75 % in the CIPRO IR . The overall incidence of adverse events reported was higher in the CIPRO IR group . The authors conclude that CIPRO XR is a safe and effective treatment for complicated UTIs . Although the limited data available do not consent to support a statistically superior efficacy or safety compared to CIPRO IR , a trend in favor of CIPRO XR is clearly evident in all efficacy and safety variables .  CIPRO XR is associated with reduced frequencies of drug-related adverse events compared to CIPRO IR OBJECTIVES Given increasing rates of co-trimoxazole resistance among uropathogens causing acute uncomplicated cystitis , fluoroquinolones , nitrofurantoin and fosfomycin are often considered as alternative empirical therapy . The choice between these drugs should depend in part on whether they are associated with the isolation of drug-resistant microbial flora . We conducted a r and omized treatment trial to assess the effects of ciprofloxacin , nitrofurantoin and fosfomycin on the rectal microbial flora of women with acute uncomplicated cystitis , including isolation of fluoroquinolone-resistant strains . METHODS Pre-menopausal women presenting with acute uncomplicated cystitis were r and omized to treatment with 3 days of ciprofloxacin , 7 days of nitrofurantoin , or a single dose of fosfomycin . Women were followed for 1 month for evaluation of clinical and microbiological responses as well as for isolation of resistant rectal E. coli . RESULTS Sixty-two women ( 25 ciprofloxacin , 17 nitrofurantoin , 20 fosfomycin ) were enrolled and eligible for analysis . All three regimens were well tolerated and result ed in > 90 % clinical and bacteriological cure . The prevalence of rectal E. coli was markedly decreased by ciprofloxacin and fosfomycin , but not by nitrofurantoin . One woman treated with ciprofloxacin had emergence of two ciprofloxacin-resistant rectal E. coli strains within 10 days of completing therapy . No emergence of resistance was observed in the other two treatment groups . CONCLUSIONS This study demonstrates that fluoroquinolone-resistant E. coli remain infrequent in the rectal flora of women with uncomplicated cystitis in Seattle . However , a 3 day course of a fluoroquinolone for treatment of uncomplicated cystitis was followed by isolation of fluoroquinolone-resistant rectal E. coli in one patient A double-blind , r and omized controlled study to evaluate the efficacy and safety of a single dose of 500 mg of ciprofloxacin versus 3 days 400 mg twice-daily of norfloxacin in uncomplicated urinary tract infection in women was design ed . Patients underwent four visits : baseline , and at 3 , 7 and 28 days . The main efficacy variables were clinical and microbiological outcome at day 7 . Analyses on both valid patients and intention-to-treat population s were performed . Two hundred and twenty-six patients ( 114 receiving ciprofloxacin and 112 receiving norfloxacin )  were considered valid for efficacy evaluation . Bacteriologic cure was 91.2 % in the ciprofloxacin group and 91.9 % in the norfloxacin group . Clinical resolution was 91.2 and 93.8 % , respectively . Both treatments were equally efficacious ( P = 0.016 ) Seventy-one adult patients with 72 infections were treated , by r and om selection , with intravenous/oral ciprofloxacin or intravenously administered ceftazidime .  Twenty-seven additional patients with 29 infections who were not appropriate for r and om assignment were treated in an open study with intravenously administered ciprofloxacin only ; the latter infections were generally more serious or were caused by ceftazidime-resistant organisms . The most common doses were ciprofloxacin , 200 mg intravenously and 500 mg orally every 12 hours and ceftazidime , 1 to 2 g intravenously every eight to 12 hours . Forty-seven ciprofloxacin-treated infections and 31 ceftazidime-treated infections were evaluable for determination of efficacy . Infections included lower respiratory tract ( 21 infections ) , urinary ( 37 infections ) , skin/soft tissue ( 14 infections ) , bacteremia/endocarditis ( four infections ) , colitis ( one infection ) , and mastoiditis ( one infection ) . Median minimal inhibitory concentrations of ciprofloxacin and ceftazidime were , respectively : for Enterobacteriaceae , Haemophilus influenzae , and Branhamella catarrhalis , no more than 0.06 and no more than 0.25 micrograms/ml ; for Pseudomonas aeruginosa , 0.25 and 4 micrograms/ml ; for Enterococcus faecalis , 1 and more than 32 micrograms/ml ; and for Staphylococcus aureus , 0.25 and 8 micrograms/ml . Ciprofloxacin , 200 mg intravenously , yielded mean serum concentrations 0.5 and eight hours post-intravenous infusion of 2.3 and 0.7 micrograms/ml , respectively . Satisfactory clinical responses were achieved in 17 ( 81 percent ) of 21 patients with intravenous/oral ciprofloxacin , 22 ( 71 percent ) of 31 patients with ceftazidime , and 20 ( 77 percent ) of 26 patients with intravenous ciprofloxacin . The most common treatment failures occurred in complicated skin/soft-tissue infections treated with intravenous/oral ciprofloxacin , complicated urinary tract infections treated with ceftazidime , and necrotizing P. aeruginosa pneumonia treated with intravenous ciprofloxacin ; the pneumonia patients all had respiratory failure and had been previously unresponsive to treatment with other appropriate drugs . Serious adverse reactions were observed in three patients , seizures with intravenous ciprofloxacin in two patients , and Clostridium difficile diarrhea with ceftazidime in one patient . We conclude that sequential intravenous/oral ciprofloxacin and ceftazidime were comparable in efficacy and safety ; the ability to change from intravenous to oral therapy is a major convenience . Intravenous ciprofloxacin was useful for more serious infections , often caused by ceftazidime-resistant organisms ABSTRACT Twelve healthy volunteers participated in this r and omized crossover study to compare the concentrations and recovery levels of fleroxacin and pefloxacin in urine and to assess their bactericidal activities against 12 strains of urinary pathogens with different susceptibilities over a wide range of MICs . The volunteers received a single oral dose of 400 mg of fleroxacin or 800 mg of pefloxacin . The mean cumulative renal excretion of unchanged fleroxacin , N-demethyl-fleroxacin , and N-oxide-fleroxacin accounted for 67 , 7 , and 6 % of the total dose , respectively . The total urinary recovery of pefloxacin and the active metabolite norfloxacin was 34 % . In the time-kill and the urinary bactericidal titer ( UBT ) studies , only the subjects ’ urine not supplemented with broth was used . With most tested organisms and both quinolones it took more than 8 h to achieve a reduction in CFU of 99.9 % ( 3 log units ) . Overall , there was a good correlation between UBTs and MICs for the strains . Against Escherichia coli ATCC 25922 the median UBTs were similar for both antibiotics and at least 1:8 for 96 h ; against the E. coli strain for which the MIC was 0.5 μg/ml the UBT was at least 1:4 for 48 h. The UBTs of both drugs against Klebsiella pneumoniae were at least 1:16 for 72 h. The UBTs for Staphylococcus aureus ( the MIC for which was 16 μg/ml ) of both antibiotics were low , and in some of the sample s , no bactericidal titers were observed . UBTs for Proteus mirabilis of pefloxacin are significantly higher than those of fleroxacin . For Pseudomonas aeruginosa the median UBTs were present for the 24-to-48-h interval . The same is true forEnterococcus faecalis . Against Staphylococcus saprophyticus , UBTs were present for at least 48 h with both quinolones . Overall , a single oral dose of 400 mg of fleroxacin exhibits UBTs comparable to those of 800 mg of pefloxacin . Therefore , it may be expected that half of the dose of fleroxacin gives comparable results in the treatment of urinary tract infections ; this should be substantiated in comparative clinical trials OBJECTIVES To evaluate the prevention of  urinary tract infections ( UTIs ) after transurethral resection of the prostate ( TURP ) in a prospect i ve r and omized study using a quinolone antibiotic ( fleroxacin ) to compare the efficacy of : ( 1 ) a single oral dose , ( 2 ) a single intravenous ( IV ) dose , and ( 3 ) an extended regimen consisting of an initial IV dose followed by oral therapy until removal of the urinary catheter , but for less than 6 days . METHODS We excluded from study patients who received antimicrobial agents within 48 hours of surgery . Single-dose prophylaxis consisted of 400 mg of fleroxacin given either orally or intravenously . The extended regimen consisted of an initial 400 mg IV dose followed by 400 mg oral each day ( patients older than 75 years , or with a creatinine clearance less than 40 mL/min , received 200 mg/day ) . UTI was defined as clinical evidence of infection plus the presence of more than 10 white blood cells (WBC)/mm3 in any urine specimen plus the presence of more than 10(4 ) cfu/mL in midstream urine specimens or more than 10(2 ) cfu/mL in catheter specimens . RESULTS Prior to TURP , 30 % 
    Output:
    
An analysis of the remaining RGTs identified therapeutic equivalence of ciprofloxacin against other antimicrobials in terms of bacterial eradication and clinical cure at the end of treatment and in subsequent stages .
The percentage of bacterial resistance was similar in both groups , while the percentage of related adverse events was significantly lower in the groups treated with ciprofloxacin .
CONCLUSIONS We conclude that ciprofloxacin is a safe and effective therapeutic alternative for the treatment of acute or complicated urinary tract infections in adults