Treatment of urinary tract infections with cefotaxime: noncomparative and prospective comparative trials

Three studies evaluated the efficacy of cefotaxime for the treatment of urinary tract infections. An open, multicenter, noncomparative trial included 477 patients who received a usual dose of 2 g of intravenous or intramuscular cefotaxime daily for five to 10 days. The maximal daily dosage in severe cases was 12 g. Pathogens included Escherichia coli and species of Citrobacter, Pseudomonas, Klebsiella, Enterobacter, Serratia, Morganella, Providencia, and Proteus. Of all the causative organisms, 83.6% were eradicated in the 271 patients who could be evaluated. The other two studies were prospective, randomized comparisons of cefotaxime (392 patients) with cefazolin (250 patients) for the treatment of urinary tract infections caused by microorganisms susceptible to both antibiotics. The treatment schedule was the same as that in the first study. Results of these two prospective studies were pooled. Cefotaxime eradicated 90% of all pathogens, and cefazolin eradicated 72%. Cefotaxime was significantly more effective (P less than 0.01) than cefazolin in eradicating E. coli and Proteus mirabilis. A satisfactory clinical response was obtained in 98.1% of patients given cefotaxime and in 87.6% of those given cefazolin (P less than 0.01).