Cefotaxime in the treatment of urinary tract infections.

This study divided UTI into three groups: (1) cystitis without involvement of the upper urinary tract or complicating factors; (2) cystitis with complicating factors, or pyelonephritis without significant complications; and (3) pyelonephritis with complications or predisposing factors. Using this classification, the effectiveness of cefotaxime was examined in three dosage regimens. A randomized study was carried out in patients with uncomplicated cystitis, in which a single dose of 0.5 g of cefotaxime was compared to a 5-day treatment of 100 mg nitrofurantoin 3 times a day. An open study was carried out on patients with more complicated infections. In complicated cystitis, on pyelonephritis without significant complications, the patients were treated with 0.5 g twice a day for 10 days. Patients with complicated pyelonephritis received 1 g twice or 3 times a day for 10 days. In uncomplicated cystitis there was no significant difference in efficacy between single-dose treatment with cefotaxime and 5-day treatment with nitrofurantoin. In 128 patients with pyelonephritis or complicated cystitis, a total of 153 strains were isolated. Of these, 145 were eliminated by cefotaxime treatment, but 8 persisted. During the subsequent observation period 4 patients relapsed and 48 developed re-infections. In 153 patients with complicated pyelonephritis the causative micro-organisms were eliminated in 138 cases. In 15, the organism was still present at the end of therapy. During the observation period 21 patients relapsed although 17 of these bacteria were still sensitive. Re-infections occurred in 49 cases.