Gesualdo L, Quarto M, Viggiani N, Germinario C, Barbuti S, Schena F P
Department of Medical Therapy, Polyclinic, Bari, Italy.
Drugs Exp Clin Res. 1989;15(6-7):309-13.
A single, selective study was performed in order to evaluate the efficacy and safety of cefotetan in the treatment of complicated urinary tract infections (UTI). Of 34 pre-treatment isolated strains, 60% were pluri-resistant to other antibiotics (ampicillin, carbenicillin, piperacillin, cefalotin, aztreonam) but only 21.2% to cefotetan. Pseudomonas aeruginosa and enterococci were resistant to cefotetan. Escherichia coli was the common strain isolated (50%). Nineteen adult patients, with complicated UTI caused by sensitive organisms, were treated with a 1 g intramuscular (i.m.) daily dose. Duration of treatment ranged from 5-15 days, with a mean of 13.75 days. Within 24-48 h and 30 days post-therapy, the infection was cured in 84% and 52% of patients, respectively. Reinfection, relapse or super-infection occurred in 42% of the cases. In only one patient, the infecting organism did not respond to treatment. The clinical response was evaluated in only seven patients with symptomatic UTI. Six of them (85.7%) were cured after therapy and the cure persisted at follow-up. In most cases, the adverse reactions were local, mild and negligible. In only 15.8% and 10.5% of patients, side-effects (diarrhoea, headache, abdominal pain, tachycardia, chill, pain and erythema in the injection site) were severe and moderate. In these cases, the adverse reactions were reversible when the therapy was discontinued. The relationship between treatment and side-effects was doubtful in two cases. It is concluded that cefotetan, administered at 1 g i.m. daily dose, is effective in treating complicated UTI caused by sensitive organisms, pluri-resistant to other antibiotics.
为评估头孢替坦治疗复杂性尿路感染（UTI）的疗效和安全性，进行了一项单一的、有选择性的研究。在34株治疗前分离出的菌株中，60%对其他抗生素（氨苄西林、羧苄西林、哌拉西林、头孢噻吩、氨曲南）多重耐药，但仅21.2%对头孢替坦耐药。铜绿假单胞菌和肠球菌对头孢替坦耐药。大肠埃希菌是分离出的常见菌株（50%）。19例由敏感菌引起复杂性UTI的成年患者，接受每日1g肌肉注射的治疗。治疗持续时间为5至15天，平均为13.75天。在治疗后24至48小时及30天内，分别有84%和52%的患者感染得到治愈。42%的病例发生了再感染、复发或二重感染。仅1例患者的感染菌对治疗无反应。仅对7例有症状UTI患者评估了临床反应。其中6例（85.7%）治疗后治愈，且随访时仍持续治愈。在大多数情况下，不良反应为局部的、轻微的且可忽略不计。仅15.8%和10.5%的患者出现严重和中度副作用（腹泻、头痛、腹痛、心动过速、寒战、注射部位疼痛和红斑）。在这些病例中，停药后不良反应可逆转。2例病例中治疗与副作用之间的关系存疑。结论是，每日1g肌肉注射的头孢替坦对治疗由对其他抗生素多重耐药的敏感菌引起的复杂性UTI有效。
