A comparison of cefaclor versus trimethoprim-sulfamethoxazole combination in the treatment of acute urinary infections

Abstract

Acute lower urinary tract infections were treated in 57 women according to a randomized protocol, using either cefaclor, a cephalosporin whose chemical structure is similar to that of cephalexin, or trimethoprim-sulfamethoxazole combination. Urine cultures were made before treatment was started, midway through the 10-day course of therapy, 1 week after therapy and 4 to 6 weeks after therapy, if possible. Urine cultures in 100 per cent of the patients became sterile during therapy and remained so 1 week after therapy. Of those patients undergoing followup cultures 4 to 6 weeks after therapy 98 per cent had sterile urine. Twenty-nine patients were randomized to cefaclor therapy and 28 received a trimethoprim-sulfamethoxazole combination. There was no difference between the 2 drugs studied in terms of efficacy. No side effects were noted with cefaclor and 2 minor side effects were noted with the trimethoprim-sulfamethoxazole combination. Cefaclor in a twice daily dosage schedule appears to be a safe and useful drug in the treatment of urinary tract infections caused by the common gram-negative organisms and it appears to be as efficacious as the trimethoprim-sulfamethoxazole combination.