title: A prospective, multicenter, randomized, double-blind study comparing ertapenem and ceftriaxone followed by appropriate oral therapy for complicated urinary tract infections in adults.
abstract: OBJECTIVE
  To compare the efficacy and safety of ertapenem, a new once-daily parenteral beta-lactam, with that of ceftriaxone for the initial empiric treatment of adults with complicated urinary tract infections (cUTIs).
  
  
  METHODS
  In a multicenter, prospective, double-blind study, patients with cUTIs were stratified as to whether they had acute pyelonephritis or other cUTIs (without pyelonephritis) and randomized to receive ertapenem, 1 g once a day, or ceftriaxone, 1 g once a day. After 3 days, patients with a satisfactory clinical response could be switched to an oral antimicrobial agent.
  
  
  RESULTS
  Of 258 randomized patients, 97 (55.4%) in the ertapenem group and 53 (63.9%) in the ceftriaxone group were evaluated microbiologically. Almost all patients in each treatment group were switched to oral therapy. The mean duration of therapy was similar in both treatment groups: parenteral, approximately 4 days; total, approximately 13 days. The most common pathogen was Escherichia coli. At the primary efficacy endpoint, 5 to 9 days after treatment, 85.6% of patients who received ertapenem and 84.9% who received ceftriaxone had a favorable microbiologic response, indicating that the two treatment groups were equivalent. The frequency and severity of drug-related adverse events were generally similar in both treatment groups.
  
  
  CONCLUSIONS
  In this study, ertapenem was as effective as ceftriaxone for the initial treatment of cUTI in adults, was generally well tolerated, and had a similar safety profile.
authors.affiliation: Hospital Universitario La Fe de Valencia, Valencia, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Jimenez-Cruz
authors.forename: Abel
authors.initials: A
authors.lastname: Jasovich
authors.forename: Jaime
authors.initials: J
authors.lastname: Cajigas
authors.forename: Qi
authors.initials: Q
authors.lastname: Jiang
authors.forename: Danielle
authors.initials: D
authors.lastname: Imbeault
authors.forename: Gail L
authors.initials: GL
authors.lastname: Woods
authors.forename: Richard M
authors.initials: RM
authors.lastname: Gesser
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000367:Age Factors; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002443:Ceftriaxone / Q000008:administration & dosage / Q000627:therapeutic use*; D002511:Cephalosporins / Q000008:administration & dosage / Q000627:therapeutic use*; D004311:Double-Blind Method; D000077727:Ertapenem; D004926:Escherichia coli / Q000187:drug effects / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000188:drug therapy; D006801:Humans; D007262:Infusions, Intravenous; D007769:Lactams; D011446:Prospective Studies; D016896:Treatment Outcome; D014552:Urinary Tract Infections / Q000188:drug therapy* / Q000382:microbiology; D047090:beta-Lactams
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D007769:Lactams; D047090:beta-Lactams; D002443:Ceftriaxone; D000077727:Ertapenem