Objective To evaluate the safety and efficacy of cefetamet pivoxil in comparison with cefixime in treating bacterial infections. Methods 99 patients with respiratory and urinary tract infections were randomly enrolled. Ten patients were excluded within the first 72 h after initiation of the study. 55 and 54 patients were evaluated for the safety of cefetamet pivoxil and cefixime respectively. 51 patients in the cefetamet pivoxil group and 48 patients in the cefixime group were evaluated for treatment efficacy. The dosage of cefetamet pivoxil was 250-500 mg and cefixime was 200 mg, twice daily orally for 7-10 days. Results The efficacy rates of cefetamet pivoxil and cefixime were 94.1％ （48/51） and 91.7％ （44/48）, and bacterial clearance rates were 95.3％ and 95.1％, respectively.Adverse reactions occurred in 9.1％ and 7.4％ in the two groups respectively. Conclusion There were no statistical differences between the two groups with respect to clinical efficacy, bacterial clearance and adverse reactions profiles.