One hundred thirty-eight patients with pyelonephritis were treated with norfloxacin, 400 mg twice daily. Women accounted for 74% of cases, and Escherichia coli was the predominant pathogen, accounting for 51% of organisms. Tests for antibody-coated bacteria (ACB) were performed in 48% of patients, and 72% (48 of 67) were positive. Forty percent of the patients had temperatures greater than 37.6 °C at the time of study entry. Patients who had both fevers and positive ACB tests had cure rates similar to those of afebrile, ACB-negative patients. Norfloxacin was also highly effective in the treatment of multiply resistant, nosocomial urinary tract infections (UTIs), in which Pseudomonas aeruginosa and E. coli predominated. It is concluded that, when used appropriately, i.e., in nonbacteremic patients who are able to absorb oral drugs, norfloxacin is a highly effective alternative modality in the therapy of certain UTIs that historically have been treated with parenteral antibiotics.

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