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Context The optimal antimicrobial regimen and treatment duration for acute uncomplicated pyelonephritis are unknown. Objective To compare the efficacy and safety of a 7-day ciprofloxacin regimen and a day trimethoprim-sulfamethoxazole regimen for the treatment of acute pyelonephritis in women. Design Randomized, double-blind comparative trial conducted from October through January Patients Of enrolled premenopausal women aged at least 18 years with clinical diagnosis of acute uncomplicated pyelonephritis, were included in the analysis. Main Outcome Measure Continued bacteriologic and clinical cure, such that alternative antimicrobial drugs were not required, among evaluable patients through the 4- to day posttherapy visit, compared by treatment group. Conclusions In our study of outpatient treatment of acute uncomplicated pyelonephritis in women, a 7-day ciprofloxacin regimen was associated with greater bacteriologic and clinical cure rates than a day trimethoprim-sulfamethoxazole regimen, especially in patients infected with trimethoprim-sulfamethoxazole—resistant strains.

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