A comparison of azlocillin and ticarcillin in the treatment of complicated urinary tract infections

Abstract

In a prospective, controlled, and randomized study, 79 patients with urinary tract infections primarily caused by Pseudomonas aeruginosa were treated with azlocillin at 8 g/day or ticarcillin at 12 g/day for 5 to 23 days. The evaluations of clinical and bacteriological responses of the patients to therapy were made by a 'blind' third-party observer. Overall, 74% of the 38 patients treated with azlocillin were cured, as were 67% of the 33 treated with ticarcillin. A favourable clinical response to azlocillin was achieved in 34 (89.4%) of the patients; 30 (93.8%) of the ticarcillin-treated patients had a favourable clinical response. Bacteriologically, administration of azlocillin eliminated the causative organisms in 31 of the infections (92.1%); the causative organisms were eliminated in 31 of the infections (96.9%) treated with ticarcillin. In both groups, in addition to bacterial persistence, treatment failures were due to bacteriological superinfection, generally with Escherichia coli or Klebsiella pneumoniae. No local reactions were reported for either treatment group. One 80-year-old patient with prostatic carcinoma treated with azlocillin had a mild and reversible decrease in renal function during therapy, and another developed a mild pruritic rash. The results of this study indicate that azlocillin at 8 g/day is as effective as ticarcillin at 12 g/day for the treatment of urinary tract infections caused by Ps. aeruginosa; both drugs were tolerated well.