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The following is a summary of “A comparison of empiric therapy with cefazolin versus ceftriaxone for patients with complicated urinary tract infections in a tertiary care veterans affairs medical center,” published in the March 2025 issue of BMC Infectious Diseases by Carcamo et al. 

Researchers conducted a retrospective study to compare cefazolin with ceftriaxone for empiric treatment of individuals with complicated urinary tract infections (cUTIs) in an inpatient setting.  

They analyzed records from a Veterans Affairs (VA) medical center, including individuals with cUTIs treated with cefazolin or ceftriaxone between November 1, 2019, and September 30, 2022. The primary outcome was 30-day clinical success, defined as symptom resolution without antibiotic re-initiation during hospitalization or relapse within 30 days of diagnosis. Secondary outcomes were hospital length of stay and Clostridioides difficile infection (CDI) within 30 days after completing antibiotic therapy.  

The results showed that 113 individuals with cUTIs met the study criteria, with 52 receiving cefazolin and 61 receiving ceftriaxone. Both groups had similar demographics, though subjective fever on admission and nephrolithiasis were more common in the ceftriaxone group, while altered mental status as the only symptom, urinary catheter use, and prior single-dose antibiotic exposure were more frequent in the cefazolin group. Clinical success was achieved in 47 of 52 (90%) with cefazolin and 53 of 61 (87%) with ceftriaxone (P = 0.56) and no significant differences were observed in hospital length of stay or CDI rates.  

Investigators concluded that empiric cefazolin therapy demonstrated safety and effectiveness in treating cUTIs within the studied VA medical center patient cohort. 

Source: bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-025-10494-5