L-613. Treatment of Urinary Tract Infections (UTI) in Women with Diabetes Mellitus (DM); Lower Recurrence Rate with Norfloxacin Compared to Nitrofurantoin or Trimethoprim
Session: Poster Session: Advances in Community-Acquired Urinary Tract Infection
Saturday, October 25, 2008: 12:00 AM
Room: Hall C
Background: Women with diabetes mellitus (DM) have a high incidence and complication rate of urinary tract infections (UTI’s). We investigated whether women with DM have lower UTI recurrence rates when treated with an antibiotic with high tissue penetration (norfloxacin) compared to antibiotics with low tissue penetration (trimethoprim or nitrofurantoin). Methods:
We used a Dutch pharmacy dispensing registration database. A total of 10,366 women with DM (17.5% pre-menopausal <=55 years) who received a first course of norfloxacin, trimethoprim or nitrofurantoin between January 1999-January 2006 were studied and the UTI recurrence rates after treatment with the different antimicrobial agents with the same treatment duration were compared. Recurrence was defined as a second prescription for the above mentioned agents or a first with amoxicillin (clavulanic-acid), fluoroquinolones, or trimethoprim/sulfamethoxazole between 6 and 30 days after the first course of antibiotics. All analyses were done separately for pre- and postmenopausal women. Results: Pre- and postmenopausal women with DM had fewer (4-16% depending on agent and treatment duration) recurrences when they were treated with norfloxacin in comparison with trimethoprim or nitrofurantoin. Only premenopausal women treated < 4 days had the same recurrence rates in all antibiotic groups. Conclusions:
In this observational study, postmenopausal women with DM had fewer UTI recurrences when treated with norfloxacin compared to trimethoprim or nitrofurantoin irrespective of the treatment duration, and premenopausal women when treated for at least 5 days.
Caroline Schneeberger1, Johannes Devries2, Peter Schneeberger3, Ron Herings4, Ronald Stolk1, Suzanne Geerlings, MD, PhD5 and  S. E. Geerlings,
MSD Role(s): Scientific Advisor (Review Panel or Advisory Committee), Received: Consulting Fee.
GSK Role(s): Scientific Advisor (Review Panel or Advisory Committee), Received: Consulting Fee., (1)University Medical Center, (2)Academic Medical Center, (3)Jeroen Bosch Hosptial, (4)Pharmo Institute, (5)Department of Internal Medicine, Division of Infectious Diseases, Tropical Medicine and AIDS, and Center for Infection and Immunity Amsterdam (CINIMA), Academic Medical Center, Amsterdam, Netherlands