Effectiveness and Tolerability of Ceftriaxone–Sulbactam–Ethylenediaminetetraacetic Acid in the Treatment of Urinary Tract Infections: A Single-center Retrospective Study

Abstract Background: Urinary tract infections (UTIs) are among the most common bacterial infections and are increasingly complicated by rising antimicrobial resistance, particularly among Gram-negative uropathogens. Ceftriaxone–sulbactam–ethylenediaminetetraacetic acid (CSE) is a combination designed to enhance activity against resistant organisms, but real-world clinical data remain scarce. Aim: The aim of this study was to evaluate the clinical effectiveness and tolerability of CSE in treating UTIs. Methods: This single-center retrospective observational study analyzed the records of hospitalized patients treated for UTIs from November 2021 to November 2023. Collected data included demographics, infection type, microbiological profile, antimicrobial therapy, and clinical and microbiological outcomes. Descriptive statistics were used, with continuous variables reported as mean ± standard deviation and categorical variables as frequencies and percentages. Results: A total of 100 patients were included, with upper UTIs accounting for 96% of cases. Escherichia coli was the predominant pathogen (83%). In vitro susceptibility testing showed high activity of CSE, with 87% susceptibility among E. coli isolates and 100% among Klebsiella, Acinetobacter, Proteus , and Pseudomonas species. CSE monotherapy (1.5 g twice daily) was administered to 98% of patients. Clinical cure or improvement occurred in 92% of cases, with a mean time to symptom resolution of 4.6 ± 2.8 days. Microbiological eradication was documented in 94% of patients with follow-up cultures. No adverse drug reactions were reported, and the mean hospital stay was 5.55 days. Conclusion: CSE demonstrated favorable clinical and microbiological outcomes and good tolerability in predominantly complicated UTIs. These findings support its potential as an effective therapeutic option, particularly in settings with a high burden of multidrug-resistant uropathogens.