Cefoperazone + sulbactam versus cefotaxime + sulbactam combination therapy for the treatment of complicated urinary tract infections in hospitalized patients: Safety and efficacy analysis

Abstract

Background: Complicated urinary tract infections (cUTIs) are one of the leading causes of the Gram-negative bacteremia which commonly seen in patients who have a functionally, metabolically, or anatomically abnormal urinary tract. In patients with cUTI, proper treatment can reduce the unnecessary rick and cost of disease progression. Aims and Objectives: The aim of the study was to compare efficacy and safety Cefoperazone + Sulbactam (CPS) versus Cefotaxime + Sulbactam (CTS) combinations in cUTI. Materials and Methods: At entry, a total of 74 patients admitted in the hospital due to cUTI were enrolled. Among 74 patients, 43 patients were given CPS while 31 patients were given CTS combinations. Five clinical symptoms (e.g., dysuria, frequency, suprapubic pain, back, and/or flank pain) were registered and scored as mild (1), moderate (2), or severe (3). The follow-up of the indoor patients was done daily until the patient is discharged. Thereafter, one follow-up visit was done within 4–9 days of after discharge, termed as a test of cure (TOC). Furthermore, one late follow-up visit (LFU) after 6–8 weeks was done, known as LFU. Clinical assessments and microbiological analysis were done at the time of TOC and LFU. The mean baseline clinical score for CPS and CTS was 10.28 ± 2.33 and 10.57 ± 2.02, respectively. Results: At TOC visit, in CPS and CTS groups, clinical scores were 1.36 ± 3.48 and 1.25 ± 3.47 in CPS and CTS, respectively, suggesting significant improvement from baseline (P < 0.005). Rate of clinical improvement at TOC visit was 87.50% and 92.00% while microbiological cure rate was 93.75% and 84.00% with CPS and CTS groups, respectively, while, at LFU visit, clinical scores in both groups were 1.65 ± 4.10 and 1.30 ± 3.56 suggesting significant improvement from baseline (P < 0.005). Clinical cure rate at LFU visit was 87.85% and 88.00% while microbiological cure rate at LFU visit was 77.00% and 76.00% with CPS and CTS groups, respectively. Conclusion: These results suggest that both regimens have no significant difference in the treatment of cUTI. The study concluded that both the combination, CTS and CTS are equally efficacious in the treatment of cUTI. The frequency and severity of drug-related adverse events were generally similar in both treatment groups.