Review of norfloxacin in complicated and recurrent urinary tract infections.

In seven studies of complicated and recurrent urinary tract infections, 285 patients were treated with norfloxacin 400 mg b.i.d. for 7-90 days. The majority of the patients were men, and many were elderly. Underlying diseases included nephrolithiasis, pyelonephritis, prostatism, bacterial prostatitis, prostate cancer, retroperitoneal fibrosis, quadriplegia/paraplegia, neurogenic bladder, and urethral stricture. Many of the infections were due to Pseudomonas aeruginosa or other multiply resistant strains. More than 95% of the pretreatment bacterial isolates were susceptible to norfloxacin. The bacteriologic cure rate ranged from 67 to 100%. Of 45 patients with chronic bacterial prostatitis, 40 (89%) were cured. Few failures of treatment were due to the emergence of bacterial resistance. Of 29 recurrent infections, 6 (20%) were caused by resistant bacteria. Both clinical and laboratory adverse reactions were infrequent and minor, and rarely required discontinuation of therapy. Norfloxacin appears to be an effective drug with an excellent safety profile for the treatment of complicated and recurrent UTIs.