The role of aztreonam in treatment of complicated urinary tract infections in children.

Urinary tract infections are common among pediatric patients, occurring in approximately 2% of children within the first 5 to 10 years of life. Most urinary tract infections are uncomplicated and respond readily to treatment. However, complications may make treatment difficult and result in serious adverse sequelae. Several characteristics of aztreonam make it an attractive alternative to aminoglycosides and certain other antibiotics for the treatment of complicated urinary tract infections in children. It has been shown, for example, that the drug is highly active against most of the pathogenic organisms responsible for urinary tract infections in the pediatric population, as well as Pseudomonas aeruginosa and many less common, aminoglycoside- and cephalosporin-resistant Gram-negative bacteria. Aztreonam is widely distributed throughout the body and achieves potentially therapeutic concentrations in the kidneys and in urine for up to 24 hours after dosing. The efficacy and safety of this agent compare favorably with standard antibiotic agents. Aztreonam is associated with high rates of microbiologic and clinical cures, and the few side effects reported have been mild and transient.