Stutman H R
Division of Pediatric Infectious Disease, Memorial Miller Children's Hospital, Long Beach, California 90801-1428.
Rev Infect Dis. 1991 May-Jun;13 Suppl 7:S582-5. doi: 10.1093/clinids/13.supplement_7.s582.
The in vitro activity, pharmacokinetics, bactericidal activity, and tissue penetration of aztreonam suggest that it may play a role in therapy for serious gram-negative bacterial infections in children. Several thousand children throughout the world received aztreonam during open or comparative clinical trials for treatment of infections including pyelonephritis, bacteremia, meningitis, skeletal infection, pneumonia, and peritonitis. Cure rates have ranged from 92% to 100%, with relapses seen mainly in children with obstructive renal lesions and those with infections caused by Salmonella. A comparative trial of aztreonam for treatment of neonatal sepsis showed it to be at least as effective as amikacin for this infection. Aztreonam yielded clinical results comparable to those of conventional combined therapy for pulmonary infection in patients with cystic fibrosis. Adverse effects in pediatric trials have been uncommon; fever, diarrhea, or rash occurred in less than 2% of treated children. Reversible laboratory abnormalities have occasionally been noted. On the basis of these data, aztreonam is considered an appropriate alternative agent for the treatment of serious gram-negative bacterial infections in neonates and children. Further comparative clinical trials will delineate specific indications.
氨曲南的体外活性、药代动力学、杀菌活性及组织穿透力表明，它在治疗儿童严重革兰氏阴性菌感染中可能发挥作用。在全世界范围内，数千名儿童在开放或对照临床试验中接受了氨曲南治疗，这些感染包括肾盂肾炎、菌血症、脑膜炎、骨骼感染、肺炎及腹膜炎。治愈率在92%至100%之间，复发主要见于有梗阻性肾脏病变的儿童以及由沙门氏菌引起感染的儿童。一项氨曲南治疗新生儿败血症的对照试验表明，其对此感染的疗效至少与阿米卡星相当。氨曲南对囊性纤维化患者肺部感染的临床疗效与传统联合治疗相当。儿科试验中的不良反应并不常见；接受治疗的儿童中，发热、腹泻或皮疹的发生率不到2%。偶尔会出现可逆性实验室异常。基于这些数据，氨曲南被认为是治疗新生儿和儿童严重革兰氏阴性菌感染的合适替代药物。进一步的对照临床试验将明确其具体适应证。
