Aztreonam, the first of the new class of
monobactams, has a narrow and specific range of bactericidal activity; it is highly active against Gram-negative aerobic pathogens but is essentially inactive against Gram-positive or anaerobic bacteria. Several unique features indicate that
aztreonam may provide an attractive choice for the treatment of serious Gram-negative
infection in adults and children. Clinical study in adults has shown
aztreonam to be highly effective against
infections of the urinary and lower respiratory tracts, the musculoskeletal system and the female genitourinary tract. It also has proved useful in neutropenic patients, including those with
cancer, and for treatment of bacterial
peritonitis,
gonorrhea,
cellulitis and
wound infections. Reported clinical and microbiologic cure rates have been comparable to those associated with traditional therapeutic approaches (85 to 100%). In the treatment of children with
urinary tract infection as well as other types of
infections,
aztreonam therapy in a dosage of 30 mg/kg given every 6 to 8 hours was associated with satisfactory clinical and microbiologic cure rates. There appear to be specific clinical situations for which
aztreonam may be an appropriate alternative to more toxic
therapies, although comparative trials are needed to delineate the exact place of
aztreonam in the armamentarium against
bacterial infection.