Ceftazidime in the treatment of urinary tract infection

Twenty-nine patients with urinary tract infection were treated with ceftazidime intramuscularly, at a dosage of 1000 mg twice daily for 7 days. The patient series was predominantly geriatric, with a mean age of 70.9 years and including 17 patients over 75 years. Nine had an in-dwelling catheter and azotaemia was found in 14 cases. In this clinically difficult group, a positive bacteriological response to treatment was obtained in 72.9% and, if patients with in-dwelling catheters are excluded, 90% were cured. Ceftazidime-resistant Streptococcus faecalis was cultured before treatment in 6 of the 8 unsuccessful cases. In the remaining 2 treatment failures, Streptococcus faecalis was isolated immediately after treatment. In terms of clinical response to therapy all patients were cured or improved. Treatment with ceftazidime was well tolerated. No subjective side-effects occurred. One patient developed a distinct but transient elevation of liver enzymes, and in 2 cases a negative direct Coombs test was temporarily positive.