Clinical experience with aztreonam in the treatment of gram-negative bacteremia

Aztreonam was used for the treatment of gram-negative bacteremia in 101 patients. In 34 instances a second antibiotic was prescribed for the treatment of suspected or documented gram-positive or anaerobic infection. The sources of bacteremia were the urinary tract (50 patients), an intraabdominal site (17), the respiratory tract (8), an intravascular site (9), and an unknown site (17). The clinical response rate was 92% (91 of 99 patients). The bacteriologic response rate was 97% (98 of 101 patients). In six of seven patients, Pseudomonas aeruginosa bacteremia was cured. Twelve patients developed superinfection with gram-positive cocci or Candida, and one patient developed diarrhea associated with Clostridium difficile. No other serious toxic effects were noted.