A comparative trial of aztreonam versus gentamicin in the treatment of urinary tract infections.

A prospective, randomized trial was conducted to compare the efficacy of aztreonam, a monobactam antibiotic, and gentamicin in the treatment of serious urinary tract infections. Fifty-five patients with a suspected or confirmed infection were randomized, 28 received aztreonam and 27 received gentamicin. Both antibiotics had a high clinical response rate (aztreonam 92%, gentamicin 85%). However, the duration of treatment was significantly shorter (p = 0.037, Wilcoxon Rank Sum Test) when aztreonam was used. There were no cases of toxicity with either antibiotic but 5 patients who received gentamicin required dose alteration. Aztreonam is well tolerated and is no less effective than gentamicin in the treatment of urinary tract infections and has advantages in convenience of use and duration of treatment.