[Aztreonam and aminoglycosides in the therapy of urinary infections associated with renal calculosis].

Renal calculosis associated with urinary tract infections due to urease-positive or -negative microorganisms poses difficult therapeutic problems. The introduction of monobactam antibiotics such as aztreonam offers a valid therapeutic alternative thanks to the action of this drug on the gram-negative organism often at the root of these infections. The above study has been carried out in 10 patients with infections due to organisms sensitive to aztreonam and aminoglucosides. Treatment with aztreonam (1 g i.m. 3 times daily) brought about sterilization lasting from 3 weeks to permanently in 5 cases. In one case sterilization was transitory and in 4 cases treatment was unsuccessful. Creatinine blood level and other biochemical parameters did not vary. Aminoglucosides alone brought about transitory sterility in 2 cases and was unsuccessful in 6. At the end of treatment, creatinine blood level had increased significantly. Given the absence of toxicity the definitely better therapeutic result, and the absence of induced resistance, aztreonam should be considered the drug of choice and should be preferred to aminoglucosides for the management of urinary tract infections due to microorganisms sensitive to both types of drugs in patients with urinary calculosis.