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.