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The efficacy and tolerance of a fixed-dose combination of 200 mg pivmecillinam and 250 mg pivampicllin was compared with that of co-trimoxazole (800 mg sulphamethoxazole plus 160 mg trimethoprim) in 42 hospital in-patients with complicated urinary tract infections. Patients received a 10-day course of tablets of either agent twice daily. The infecting organisms, which were Enterobacteriaceae (79%) and enterococci (21%), were eradicated in 17(89%) of the 19 patients given co-trimoxazole and in all 23 subjects who received pivmecillinam/pivampicillin. Sixteen (89%) of the 18 symptomatic patients responded clinically to co-trimoxazole. Pivmecillinam/pivampicillin was effective in 19 (95%) of 20 patients with symptomatic infections. There was a fairly good correlation between the bacteriological and clinical responses. No serious side-effects were recorded and all patients completed the prescribed course of treatment.
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