Clinical evaluation of aztreonam for serious gram-negative bacterial infections

In an open study aztreonam was evaluated for efficacy and safety in 20 hospital in-patients presenting with presumptive or confirmed hospital acquired aerobic gram-negative infections. The overall clinical cure rate was 100% (19/19) with a corresponding microbiological cure rate of 100% in those patients in whom an organism was isolated initially (17/17). Reinfection with enterococcus occurred in 2 patients with UTI within a week of stopping aztreonam and one patient developed superinfection during treatment, but none were given any additional therapy. No evidence of drug-associated toxicity was found on any of the laboratory evaluations. One patient developed diarrhea 3 days after starting therapy, was withdrawn from the study and subsequently excluded from the analysis. One other patient remained febrile despite evidence of clinical and microbiological cure. Both these incidents were thought to be possibility drug-related. This study confirms aztreonam as a safe and effective way to treat patients with serious gram-negative infections.