Aztreonam therapy for serious gram-negative bacillary infections

Fifty episodes of gram-negative bacillary infection, including episodes of bacteremia, pneumonia, and skin and soft tissue, complicated urinary tract, and abdominal infections, were treated with aztreonam. Eighty-eight percent of patients were cured of their infection, including all nine patients with bacteremia and 15 of 17 patients with pneumonia. Thirty percent of all infections were caused by Pseudomonas, and all of these responded to treatment with aztreonam. A low incidence of toxicity and a high rate of efficacy make treatment with aztreonam as a single agent feasible. When gram-positive or anaerobic organisms were encountered or their presence in the infection was suspected, additional agents effective against these organisms were necessary for cure.