COMPARATIVE-STUDY OF AZTREONAM AND CEFAMANDOLE IN THE TREATMENT OF SERIOUS URINARY-TRACT INFECTIONS

  • 1 January 1983
    • journal article
    • research article
    • Vol. 5  (6) , 385-390
Abstract
In a single blind study, the efficacy of aztreonam (Az), a novel monocyclic .beta.-lactam antibiotic, was compared to that of cefamandole (Cef) in the treatment of serious urinary tract infections (UTI). Twenty-one patients were studied (6 men and 15 women, 18-75 yr old), 12 suffering from an upper and 9 from a lower UTI; 14 of them received Az and 7 Cef (2:1 ratio), according to a prospective randomization schedule. Az or Cef were administered i.m. (1 g every 8 h) for 5-10 days. Patients were followed up for 28-42 days after end of treatment. The following bacteria were isolated in the urine cultures: Escherichia coli (in 14 cases),Proteus sp. (4), Klebsiella sp. (2) and Pseudomonas sp. (in 1 case) All 21 bacterial isolates were susceptible to Az; 19 of them were susceptible to Cef (the Pseudomonas strain was sensitive to Az but resistant to Cef). During the entire observation period, 13 cures and 1 relapse were observed in the Az group and 5 cures and 2 relapses in the Cef group. Az was as well tolerated as cefamandole; no major side effects were observed in either group. In 4 Az and 3 Cef patients, a rise of serum glutamic oxaloacetic transaminase and serum glutamic pyruvic transaminase (up to 2 1/2 times the upper normal limits) was observed; it subsided a few days after the end of treatment. Thus, Az is at least as effective, safe and well tolerated an antimicrobial agent for the treatment of serious urinary tract infections as cefamandole; Az deserves a large scale, systematic trial in all infections caused by gram-negative bacteria.