A comparative study on ceftazidime and cefoperazone in the treatment of urinary tract infections by a double blind method

Abstract

The clinical efficacy, safety and usefulness of Ceftazidime (CAZ) in complicated urinary tract infectionswere evaluated in comparison with Cefoperazone (CPZ) in double blind manner, and thefollowing results were obtained.CAZ 1g/day, CAZ 2g/day or CPZ 2g/day was administered by intravenous drip infusion twice dailyfor 5 days.In the overall clinical efficacy evaluation according to the criteria proposed by UTI committee in Japan, the efficacy rates were 63% in 125 cases in the CAZ 1g/day group, 68% in 119 cases in the CAZ 2g/day group and 52% in 119 cases in the CPZ 2g/day group, with no significant difference among thethree groups (H-test). When 2 groups were compared (X2-test), however, the CAZ 2g/day was shown tobe superior over CPZ .2 g/day with statistically significant difference. As to the clinical efficacy classifiedby the type of infections, CAZ (both 1g/day and 2g/day) was more effective than CPZ (2g/day) withstatistically significant difference in polymicrobial infections. It was noteworthy that in the G-5 group, CAZ 1g/day was significantly better than CPZ 2g/day.The elimination rates in bacteriuria were 53%, 52% and 45%, in CAZ 1g/day, CAZ 2g/day and CPZ 2g/day, and the clearance rates in pyuria were 35%, 33% and 23%, respectively, with no significantdifference among the three groups. In the clearance + decrease rates, however, the CAZ 1g/day and CAZ 2g/day groups showed better results than CPZ 2g/day group with statistically significantdifference.In the bacteriological response, CAZ 1g/day and 2g/day showed statistically higher eradicationrates than CPZ 2g/day in the total number of organisms and gram negative bacteria, but in gram positivebacteria, CPZ 2g/day showed higher eradication rates than CAZ 1g/day with statistically significantdifference. When reviewed for each organism, CAZ 1g/day and 2g/day showed higher eradication ratesthan CPZ 2g/day in S. marcescens with statistically significant difference; however, there was nosignificant difference among the three groups in the other organisms. Number of organisms whichemerged after treatment was large with S. faecalis and Yeast-like organisms in all the three groups. No severe adverse reaction or abnormal laboratory finding was observed in any group; therefore, there was no significant difference among the three groups. From the above results, CAZ was judged to be an antibiotic with clinical usefulness equal to, or evenhigher than that of CPZ.