Eradicating Organisms in Urinary Tract Infection Two studies suggest sisomicin is superior to gentamicin ...

In a randomised double-blind study, 55 men and 10 women with urinary tract infections (mainly complicated) received IM sisomicin 50-75 mg bid for 7-10 days or IM gentamicin 60-80 mg bid for~ 10 days. 94% of isolates from sisomicin recipients were eliminated after treatment compared with 70% of isolates from the gentamicin group. This correlated well with in vitro susceptibility; sensitivities being 94 vs 72%, respectively. A cure (resolution of symptoms and signs) was achieved in 29 sisomicin-treated patients (85%) and 15 gentamicin-treated patients (48%). A marked or moderate improvement was obtained in 4 and 1 sisomicin recipients, respectively, compared with 4 and 7 gentamicin recipients, respectively. Five of the latter group were treatment failures. Thus, sisomicin proved significantly more effective than gentamicin in the treatment of urinary tract infections. Chinnowami C. Sharma SD. Current Therapeutic Research 38: 904-910. Dec 1985

In a randomised double-blind trial, 33 men and 27 women received IM sisomicin 50-75 mg bid or IM gentamicin 60-80 mg bid for urinary tract infections. 30 patients received each regimen for 7-10 days.

All isolates from the sisomicin group were susceptible in vitro compared with 82% of the gentamicin group isolates. Significantly more sisomicin patients (28, 93.3%) were cured (resolution of symptoms and signs) than gentamicin patients (18, 60%) and this was achieved in a significantly shorter amount of time (a response was achieved in the former group 3-4 days earlier). No side effects were reported or detected and sisomicin was 'significantly superior' to gentamicin in this indication. Acharya VN, Almeida AF, Sharma SD. Current Therapeutic Research 38: 911-917, Dec 1985

.. . and norfloxacin appears more effective than pipemidlc acid . .. In an open study, 26 women and 14 men received norfloxacin 400mg bid or pipemidic acid 400mg bid for

complicated urinary tract infections. All patients had underlying illnesses; most were obstructive in nature. 20 patients received each regimen for 10 days.

Patients with a cure, relapse or persistence numbered 16 (80%), 3 (15%), and 1 (5%), respectively, at the final follow-up 1 month after the end of norfloxacin treatment. Corresponding figures for pipemidic acid were 12 (60%), 4 (20%), and 4 (20%). Pathogens were more successfully cleared by norfloxacin; after 2 and 3 days of therapy 45 and 90% of patients , respectively, had sterile urine compared with 5 and 40% given pipemidic acid, respectively.

No side effects were reported and the results suggested that norfloxacin acts more quickly and effectively than pipemidic acid in the treatment of complicated urinary tract infections. Cristians P, lovene MR, Mirone V, Passarella E. Clinical Trials Journal22: 456-462, No 5, 1985

.. . while ticarclllln + clavulanlc acid compares well with plperacillln A comparative study of IV ticarcillinjclavulanic acid (3g + 200 mg, respectively, tid) and IV piperacillin (200

mgjkg daily) was conducted in 78 inpatients with urinary tract infections in which E. coli was the predominant pathogen. Of the 37 evaluated ticarcillinjclavulanic acid-treated patients, the causative pathogens were eliminated in 91% of infections (39/43). Relapse occurred in 3 patients, 1 organism was resistant and 4 reinfections or superinfections occurred. 77% of pathogens were eliminated in the piperacillin group with resistance shown by 7 organisms. There were 3 relapses and 5 reinfections or superinfections. A clinical cure or improvement was seen in 97% of patients in both groups. Cox CE. American Journal of Medicine 79 (Suppl. 5): IJ8.90, 29 Nov 1985

8 INPHARMA"' 15 Feb 1986 0156-2703/86/1005-QOOBj0$01.00/0 © ADIS Press