Cefpodoxime Flunks as a First-Line UTI Drug

Uncomplicated urinary tract infection (UTI) in women is easy to treat — so easy that guidelines advise reserving fluoroquinolones like ciprofloxacin for more-serious infections (Clin Infect Dis 2011; 52:e103). However, without the quinolones, the list of first-line drugs for a standard-issue Escherichia coli UTI is quite short.

In a recent, double-blind, randomized trial, researchers compared the oral third-generation cephalosporin cefpodoxime (Vantin) with ciprofloxacin in 300 young, healthy women with uncomplicated UTI. Treatment lasted for 3 days in each group.

Compared with women who received ciprofloxacin, those who received cefpodoxime were significantly less likely to sustain a microbiologic cure within 1 week after treatment (81% vs. …