Therapy of cystitis with nitroxoline-NitroxWin: Prospective, multicenter, non-interventional study and microbiological resistance surveillance

IntroductionAccording to the AWMF S3 guidelines, nitroxoline is one of the antibiotics of first choice for the treatment of uncomplicated cystitis (UC) in women.Under real-world conditions, the clinical effectiveness of nitroxoline should be tested in a prospective, multicenter, non-interventional study (NIS) and the resistance of Escherichia coli to nitroxoline. Material and MethodsPatients with UC and treatment with nitroxoline (recommended dosage 250 mg 3 times daily for 5 days) were recruited by urologists, general practitioners and internists working in family medicine across Germany from April to December 2022 and followed up over a period of 21-28 days.The diagnosis and course of therapy were assessed using the ACSS questionnaire and laboratory tests (leukocyturia, etc.).Independently of the NIS, Escherichia coli urine isolates were collected in 23 laboratories in the period 2019-20 as part of a nationwide resistance surveillance and their sensitivity to nitroxoline was tested. ResultsOf 316 patients with a mean (SD) age of 57.2 (20.4;median 62.5) years who were included in the NIS, the therapy was clinically successful at the time of the "test of cure" in 193/248 (86.3%) in the per-protocol group and 193/263 (81.4%) in the intention-to-treat group.96% of the patients rated the tolerance of nitroxoline as "very good" or "good".All 272 Escherichia coli isolates tested were nitroxoline-sensitive.