Cefpirome versus ceftazidime in the treatment of urinary tract infections.

In an open, randomized multiclinic trial, hospitalized patients with upper or complicated lower urinary tract infections requiring treatment with a parenteral antibiotic were randomized to receive 1 g doses of cefpirome (594 patients) or ceftazidime (303 patients) 12 hourly for at least five days. Cefpirome was considerably more active in vitro than ceftazidime against Gram-positive pathogens isolated from the urine samples. At the early follow-up, 2-15 days after treatment, clinical cure was achieved in 86% and 82% of the patients in the cefpirome and ceftazidime groups respectively. Elimination of the causative pathogen without recurrence or early reinfection was achieved in 87% of the patients in both groups. Drug related adverse events occurred in 8.9% of cefpirome treated patients and in 4.6% of those receiving ceftazidime. No specific type of adverse reaction accounted for this difference. Treatment was discontinued because of adverse events in 2.5% and 1.7% of the patients respectively. Cefpirome was found to be safe and at least as effective as ceftazidime for the treatment of urinary tract infections in hospitalized patients.