AIM: To evaluate the safety and efficacy of cefetamet pivoxil vs cefixime in the treatment of acute bacterial infections. METHODS: A multicenter randomized controlled clinical trial was conducted. Ninety eight patients (M 43, F 55; age 40 a± s 13 a) with acute bacterial infections of cefetamet group were given cefetamet pivoxil 250 500 mg, po , bid, for 7 14 d, and ninty five patients (M 44, F 51; age 42 a±14 a) of cefixime group were given cefixime 200 mg, po , bid, for 7 14 d. RESULTS: The overall clinical efficacy rates were 95 % and 94 %, the bacterial clearance rates were 96 % and 94 %, the bacterial sensitive rates were 98 % and 96 %, the adverse reaction rates were 7 % and 6 %, respectively. There was no statistical significance between two groups ( P 0.05). CONCLUSION: Cefetamet pivoxil and cefixime are effective and safe in the treatment of acute bacterial infections.