In a randomized double-blind comparison of
cefonicid (dose, 1.0 g every 24 hr) and cefmandole (dose, 1.0 g iv every 6 hr), 147 hospitalized patients (105 men, 42 women) with
urinary tract infections (UTIs) were assessed. Ninety-one of the men had complicated UTIs. For the 62
cefonicid-treated men, 61 of 62 etiologic pathogens were eliminated. For 17 patients,
reinfection with the pretherapy pathogen occurred in the five- to nine-day posttherapy follow-up. Overall cure rate for
cefonicid in the treatment of complicated UTIs was 71%. For the 29
cefamandole-treated men, 28 of 29 etiologic pathogens were eliminated.
Reinfection occurred in nine patients. Overall cure rate for
cefamandole in the treatment of complicated UTIs was 66%. All 14 men (nine receiving
cefonicid; five,
cefamandole) with uncomplicated
infection were cured. For 25
cefonicid-treated women, cure rate was 84%; one of the failures was due to persistence of the pathogen; three were
reinfections during follow-up. For 17
cefamandole-treated women, the cure rate was 82%; two of the failures were due to persistence of the pathogen, and one was a
reinfection. Similar, minimal adverse reactions occurred with both drugs.
Cefonicid is as effective as
cefamandole in curing complicated UTIs in men and uncomplicated
infections in both sexes.
Cefonicid, however, offers the advantage of once-daily
therapy.