Treatment of urinary tract infections in gynecological patients. A randomized study comparing pivampicillin-pivmecillinam with trimethoprim-sulphamethoxazole.

Eighty-two gynecological patients with clinical signs of a lower urinary tract infection (UTI) were randomized to 10 days' treatment with either a fixed combination of pivampicillin-pivmecillinam (PAPM) or trimethoprim-sulphamethoxazole (TMPS). The effect of treatment could be evaluated in 25 patients on PAPM and in 19 on TMPS, who had bacteriologically verified UTI and who completed treatment and check-ups. All strains were sensitive in vitro to the respective antibiotic combination used. Treatment eradicated the original pathogen in 75-80% of the cases, 64% of the patients on PAPM and 47% on TMPS having sterile urine 3 weeks after end of treatment. Side effects could be evaluated in 76 patients. Two patients on PAPM and 8 on TMPS had to discontinue treatment due to side effects. Including abnormal values for hematology, liver and renal parameters, significantly fewer side effects (p = 0.038) were noted on PAPM (7/40) than on TMPS (15/36).