There are several areas in which the use of
aztreonam seems logical.
Infections caused by organisms sensitive to
aztreonam that are known to be multiresistant to other agents can be treated directly with
aztreonam in single, directed
therapy, thus making the use of more toxic agents unnecessary. In types of
infection in which both gram positive and gram negative bacteria are present,
aztreonam can replace the usual
aminoglycoside component of the therapeutic regimen. In settings of
mixed infections suspected of being caused by
drug-resistant strains of Enterobacteriaceae and/or P. aeruginosa,
aztreonam can be combined with an agent active against gram positive organisms or with one active against anaerobes.
Aztreonam has proven to be effective, safe therapy for serious and life-threatening
infections caused by multiresistant aerobic gram negative bacteria. It should be used in combination with drugs that inhibit gram positive species if the etiology of the
infection is not known, particularly in the immunocompromised, neutropenic patient. Doses of 1 g every 8 to 12 hours will be adequate for treatment of
infections caused by most Enterobacteriaceae. Whether 2 g doses every 8 hours would be preferred for treatment of systemic
Pseudomonas infections remains to be determined. Urinary
infections caused by gram negative bacteria can be treated with 500 mg administered IM once or twice daily. The dosage of
aztreonam should be adjusted in patients with
renal failure. Clearly,
aztreonam is a useful addition to the
antimicrobial agents available to the physician.