Ceftazidime, an open randomized comparison of 3 dosages for genitourinary infections

Ceftazidime, a new beta-lactamase resistant aminothiazo-oyl cephalosporin with a broad spectrum of antibacterial activity against gram-positive and gram-negative bacteria, including Pseudomonas species, was evaluated clinically for efficacy and safety at 3 dosage levels in patients with acute genitourinary tract infection. Sixty patients with infections, including cystitis, pyelonephritis, epididymitis and prostatitis, were assigned randomly to 1 of the 3 dosage regimens: 250, 500 or 1,000 mg. administered intramuscularly every 12 hours. Patients were evaluated bacteriologically and clinically during the course of treatment and after treatment. All patients became asymptomatic and showed clinical improvement or cure within 48 to 72 hours regardless of dosage. Bacteriological success, namely eradication of the pathogen during therapy with no recurrence of superinfection during followup, was attained in 95 per cent of the patients with uncomplicated infections and in 61 per cent of those with complicated infections. Superinfections accounted for most of the noncures, particularly with the 250 mg. regimen. The difference in success rates between the 250 mg. dosage, and the 500 mg. and 1 gm. dosages in patients with complicated infections was statistically significant. Injections were well tolerated without significant side effects. No clinically important variations in laboratory tests were observed. The results indicate that ceftazidime is a useful third generation cephalosporin for complicated and uncomplicated genitourinary infections but it is recommended that the 250 mg. dosage not be used in patients with complicated infections.