A multicenter comparative trial of aztreonam in the treatment of gram-negative infections in compromised intensive-care patients.
A multicenter comparative trial was conducted in 4 university hospitals to evaluate the efficacy of aztreonam, a new monobactam antibiotic. All patients enrolled in the study were admitted to the intensive-care unit with severe underlying conditions. A total of 167 infections were documented in 157 patients (78 pneumonia, 26 urinary tract infection, 23 peritonitis, and 40 septicemia). The study was performed in 2 phases. In phase 1, 49 patients receiving aztreonam were compared with 26 receiving amikacin. These two drugs were administered as the sole coverage against gram-negative bacilli. In phase 2, 48 patients treated with aztreonam were compared with 34 who received a synergistic combination of amikacin and a broad-spectrum beta-lactam. The results suggest that aztreonam can be used as monotherapy in the treatment of systemic gram-negative infections with an efficacy comparable with that of standard antimicrobial therapy. Aztreonam is probably more effective than amikacin in treating respiratory tract infections and it is at least as effective as a beta-lactam-aminoglycoside combination. An adequate standard dosage of aztreonam could be established as 3-4 g/day in compromised patients, and it should be combined with gram-positive coverage when used empirically.
Rabinad
E
E
Squibb Medical Research Department, Barcelona, Spain.
Bosch-Perez
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000617:Aminoglycosides; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D001398:Aztreonam / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy*; D003422:Critical Care; D003428:Cross Infection / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D005260:Female; D006090:Gram-Negative Bacteria; D006801:Humans; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D010538:Peritonitis / Q000188:drug therapy; D011014:Pneumonia / Q000188:drug therapy; D018805:Sepsis / Q000188:drug therapy; D013030:Spain; D014552:Urinary Tract Infections / Q000188:drug therapy
D000617:Aminoglycosides; D000900:Anti-Bacterial Agents; D001398:Aztreonam