Ceftibuten is an orally active
third generation cephalosporin with increased potency against members of the Enterobacteriaceae. In this study, 74 women with acute uncomplicated
urinary tract infection (UTI) were enrolled in an open study to evaluate the safety and efficacy of this new
antibiotic. Patients were treated with 400 mg
ceftibuten once daily for seven days and followed for four to six weeks after cessation of
therapy. All pathogens were eradicated during treatment, including five
coagulase-negative staphylococci that were resistant to
ceftibuten. At five to nine days posttreatment, 93% of patients were cured. Of the five
recurrent infections, four patients had a relapse and one had a
reinfection. By four to six weeks posttreatment, five additional patients had
recurrent infections. The overall cure rate was 85% in this study. Most
ceftibuten-associated adverse effects were mild and involved the gastrointestinal tract.
Diarrhea was the most commonly reported side effect. Of the eight (11%) patients who developed
diarrhea, three had a positive
latex agglutination test for Clostridium difficile. The
diarrhea resolved in all patients without sequelae.
Ceftibuten was effective and generally safe in the treatment of women with acute uncomplicated UTI. The high incidence of
diarrhea observed in this study is a concern.