Patient description: The patients is a 25-year-old G1 P1 pregnant woman who is 24W3D gestational old who developed a sudden unset of fever and chills, accompany with nausea and vomiting. She also complains of dysuria, urgency and frequency. She also reports some severe pain in the flank. Her vital signs are: T = 39.7ºC, P = 117, R = 20, and BP = 113/74 mm Hg. Physical examination reveals tenderness on palpation of both costovertebral angles. She has no history of recurrent UTI prior to her pregnancy or any other underlying disease. The urine culture showed Gram-negative rod-shaped bacterial cells, leukocytes, and leukocyte casts. The blood culture is negative. A CBC shows Hb 12.9 g/dL, Hct 39%, MCV 76 fL, WBC count 14,120/µL.

Clinical trial eligibility criteria: eligible ages (years): 18.0-999.0,  Urinary Tract Infections Men or non-pregnant women, 18 years of age or older with a suspected complicated urinary tract infection with an onset of symptoms 72 hours or less prior to study entry Patients must present with a least one sign or symptom of a lower UTI (dysuria, urgency, frequency, suprapubic pain) or for spinal cord injury patients if such symptoms are not present, at least one of the following: fever (T > 38º C or 100.4º F orally), onset of urinary incontinence, increased spasticity, autonomic hyperreflexia, increased sweating, or cloudy and odorous urine Patients must have at least one of the underlying conditions Indwelling urinary catheter or intermittent catheterization mL of residual urine after voiding Neurogenic bladder Obstruction due to nephrolithiasis, tumor or fibrosis Urinary retention due to benign prostatic hypertrophy, bladder cancer or other urological anatomic abnormalities Patients must have pyuria prior to enrollment (within 48 hours) defined as > 10 leukocytes/mm3 in unspun urine by hemocytometer or > 5 leukocytes/hpf in resuspended sediment of centrifuged urine Patients must have one clean-catch, midstream urine culture or culture from catheter (obtained using sterile technique, not from a Foley bag) that was obtained within 48 hours of enrollment and had a positive results: 1. Defined as >= 100000 CFU/mL (>= 10000 CFU/mL for S. saprophyticus) for a causative pathogen 2. If more than 1 pathogen is identified, each should be present at a colony count >= 100000 CFU/mL (>= 10000 CFU/mL for S. saprophyticus) to be included in the analysis 3. For catheterized patients two or more pathogens (>= 100000 CFU/mL) (>= 10000 CFU/mL for S. saprophyticus) isolated from a baseline urine culture will be considered contaminants unless simultaneous blood culture yields the same pathogen(s) 4. The causative pathogen must be susceptible to ciprofloxacin on in vitro susceptibility testing 5. Enrollment and start of treatment is permitted prior to the availability of the culture report  Have a history of allergy to quinolones Are unable to take or inability to tolerate oral medications History of prostatitis or epididymitis Have signs and symptoms of pyelonephritis [all of the following: fever (T>38° C/100.4° F orally), chills, and flank pain or costovertebral angle tenderness] Have an intractable infection requiring > 14 days of therapy Have an uncomplicated UTI Have a renal transplant Have ileal loops or vesico-ureteral reflux Have a ciprofloxacin-resistant pathogen upon urine or blood culture Have received systemic antimicrobial therapy within 48 hours prior to enrollment