Comparison of three days' therapy with cefcanel or amoxicillin for the treatment of acute uncomplicated urinary tract infection

The clinical and bacteriologic efficacy of 3 days of cefcanel daloxate therapy, compared with 3 days of amoxicillin for the treatment of acute uncomplicated urinary tract infection was compared in a prospective randomized double-blind multicentre study. 400 subjects were randomized to receive cefcanel daloxate and 199 to receive amoxicillin. 166 (77% of 215 evaluable cefcanel daloxate subjects and 72 (77% of 94 evaluale amoxicillin subjects evidenced bacteriologic elimination at short-term follow-up, while in 149 (69% and 67 (71% respectively, clinical symptoms disappeared. At long-term follow-up, 150 (70% cefcanel daloxate and 65 (69% amoxicillin subjects evidenced bacteriological elimination, while in 150 (70% and 61 (65% clinical symptoms disappeared. There were no significant differences in outcome between the 2 therapeutic regimens. Adverse events were similar in the 2 groups. In additional analyses, antimicrobial efficacy diminished significantly with increasing age, preth-erapy in vitro susceptibility was significantly associated with bacteriological failure at the short-term visit, and subjects with low quantitative counts pretherapy had clinical outcomes similar to those with quantitative counts ≥10⁵ cfu/ml at the short-term outcome. These data suggest that cefcanel daloxate and amoxicillin are comparable as regards efficacy and adverse effects for 3-day therapy of acute uncomplicated urinary tract infection. The observed cure rates, however, are lower than those reported for other agents such as trimethoprim/sulfa-methoxazole or quinolones for short course therapy.