Acute renal failure, skin rash, and eosinophilia associated with aztreonam

A case of acute renal failure associated with aztreonam therapy is reported. A man, age 70, with infections due to Klebsiella pneumoniae and Enterobacter cloaca was treated for 9 days with aztreonam and presented with a generalized maculopapular rash, fever, eosinophilia, worsening renal function and increased IgE levels and eosinophiluria. Aztreonam was then discontinued and the patient was treated with supportive measures and steroids and his renal failure reversed over the course of 5 days. This appears to be one of the first cases of acute renal failure associated with aztreonam.