Role of aztreonam in lower respiratory tract infections.

Pneumonia caused by Gram-negative bacteria is a major cause of morbidity and mortality among hospitalized and immunocompromised patients. Most antibiotic regimens used to treat these pulmonary infections include aminoglycoside antibiotics. Since achievable serum and tissue levels of aminoglycosides are limited by dose-related nephrotoxicity and ototoxicity, alternative forms of antibiotic therapy would be desirable. Aztreonam, the first clinically available monobactam antibiotic, achieves high serum levels and adequate levels in bronchial secretions and lung parenchyma for efficacy against most Gram-negative pathogens implicated in nosocomial pneumonias. The results of early clinical trials comparing aztreonam with aminoglycosides for treatment of Gram-negative bacterial pneumonias indicate that this monobactam antibiotic is a safe, effective alternative to aminoglycoside therapy.