Clinical Outcome Pattern in Diabetic Patients with Complicated Urinary Tract Infections Treated with Ceftriaxone-Sulbactam-EDTA. A Retrospective Study

Abstract

Objective: In general, infectious diseases are more frequent and/or serious in patients with diabetes mellitus, complicated further by antimicrobial resistance which potentially increases their morbi-mortality. The objective of this study was to determine the clinical utility of CSE-1034 (Ceftriaxone+Sulbactam+EDTA) in diabetic patients with complicated urinary tract infections (cUTIs). Methods: Diabetic patients with cUTIs who received CSE-1034 as empiric therapy were screened and further analyzed. CSE-1034 therapy was started empirically in all these subjects and continued or discontinued based on culture susceptibility profile and clinical outcome. Results: Out of 85 patients admitted for cUTI, 38 patients met our inclusion criteria and were included in this study. E. coli (50.0%) was the predominant pathogen isolated followed by K. pneumoniae (21.1%). In vitro susceptibility testing had shown no susceptibility of baseline pathogens to levofloxacin, gentamicin, ceftriaxone, cefepime and cefazolin. The susceptibility rates to other antibiotics were pip-taz (23.6%), β-lactam-β-lactam inhibitor (BL-BLI) combinations (18.4-23.6%), meropenem (63.1%) and CSE-1034 (100%). 92.1% of the patients were cured with CSE-1034 empiric therapy and 7.9% with alternate meropenem therapy. Conclusion: Our study suggested that CSE-1034 alone appears to be effective drug for the treatment of multi-drug resistant cUTI in diabetic patients and can serve as effective alternate to meropenem and replacement for BL-BLI combinations.