A Comparative Study of Ticarcillin and Gentamicin in the Treatment of Complicated Urinary Tract Infections

Abstract

Ticarcillin is a semisynthetic penicillin for parenteral use with an antibacterial spectrum similar to that of carbenicillin but better in vitro activity against Pseudomonas aeruginosa.

The two antibiotics ticarcillin and gentamicin were compared in a prospective randomized study of 80 elderly male patients with complicated urinary tract infections due to hyperplasia of the prostate, cancer of the prostate, urethral strictures, and stones. The two groups of patients were comparable as to infecting microorganisms and underlying urinary tract pathology. No patients had indwelling catheters. All microorganisms isolated were sensitive to the two antibiotics by the disc sensitivity test. Ticarcillin was diluted in 0.5% lidocaine to reduce pain on injection. Both antibiotics were well tolerated but the patients receiving gentamicin showed a statistically but not clinically significant increase in the blood urea nitrogen and serum creatinine values following treatment suggesting slight renal toxicity. Both antibiotics were effective in eradicating the infections with no significant difference between the two groups in cure rate as defined by a negative urine culture one week following discontinuation of the treatment.

Ticarcillin (BRL 2288, α-carboxy-3-thienylmethylpenicillin, disodium salt) is a semisynthetic penicillin with an antibacterial spectrum similar to that of carbenicillin. When compared to carbenicillin, it is of particular interest because ticarcillin is significantly more active in vitro against Pseudomonas aeruginosa, slightly more active against E. coli and it is active against certain proteus species (Beecham-Massengill Pharmaceuticals, 1974). Ticarcillin is not absorbed after oral administration.

The present study was carried out to compare the safety and efficacy of ticarcillin and to compare it to gentamicin in the treatment of complicated urinary tract infections in an elderly male patient population.