Dratwa M, Glupczynski Y, Lameire N, Matthys D, Verschraegen G, Vaneechoutte M, Boelaert J, Schurgers M, Van Landuyt H, Verbeelen D
Division of Nephrology, Brugmann University Hospital, Brussels, Belgium.
Rev Infect Dis. 1991 May-Jun;13 Suppl 7:S645-7. doi: 10.1093/clinids/13.supplement_7.s645.
In a multicenter open study, intraperitoneal aztreonam was used together with vancomycin, cloxacillin, or flucloxacillin for initial empiric treatment of peritonitis associated with continuous ambulatory peritoneal dialysis (CAPD). Monotherapy with aztreonam was continued in 34 episodes of gram-negative peritonitis in 28 patients. The microorganisms isolated included Escherichia coli, Acinetobacter species, Pseudomonas species, and Klebsiella species. In three episodes, two organisms were cultured. Microbiologic assessment revealed cure in 27 episodes, cure with relapse in two, cure with superinfection in one, and treatment failure in four (with resistance to aztreonam in three). As assessed by clinical criteria, 27 episodes were cured, five failed to respond, and two responded partially. No adverse reactions to aztreonam were observed. Comparison of these 34 episodes with 35 episodes in historical controls (treated mainly with aminoglycosides and/or trimethoprim-sulfamethoxazole) showed significantly higher rates of cure (84% vs. 51%) and of survival (97% vs. 86%) as well as lower rates of catheter removal (65% vs. 87%) with aztreonam. Thus aztreonam is a safe and efficient agent for the treatment of peritonitis caused by gram-negative organisms in patients undergoing CAPD.
在一项多中心开放性研究中，将氨曲南与万古霉素、氯唑西林或氟氯西林联合用于持续性非卧床腹膜透析（CAPD）相关腹膜炎的初始经验性治疗。28例患者的34例革兰阴性菌腹膜炎发作中继续采用氨曲南单药治疗。分离出的微生物包括大肠杆菌、不动杆菌属、假单胞菌属和克雷伯菌属。3例发作中培养出两种微生物。微生物学评估显示，27例治愈，2例治愈后复发，1例治愈但出现二重感染，4例治疗失败（3例对氨曲南耐药）。根据临床标准评估，27例治愈，5例无反应，2例部分反应。未观察到对氨曲南的不良反应。将这34例发作与历史对照中的35例发作（主要用氨基糖苷类和/或甲氧苄啶-磺胺甲恶唑治疗）进行比较，结果显示氨曲南治疗的治愈率（84%对51%）和生存率（97%对86%）显著更高，导管拔除率更低（65%对87%）。因此，氨曲南是治疗CAPD患者革兰阴性菌引起的腹膜炎的一种安全有效的药物。
