Aztreonam is considered appropriate therapy in the following situations.

1. Culture and sensitivity proves isolated organism is resistant or only moderately sensitive to aminoglycosides and is sensitive to aztreonam.

2. Culture and sensitivity proves sensitivity to Aztreonam and use of aminoglycosides is undesirable due to pharmacokinetic parameters or previous toxicity.

3. For empiric therapy in a patient who has exhibited nonresponse to current or previous therapy and where likely etiology of infection is gram negative bacillus. Specifically in the following considerations:

1. Nosocomial infections which are suspected to be gram negative bacillary.

2. Serious chronic urinary tract infection.

4. In combination with antistaphylococcal, antistreptococcal or antianaerobic agents as an alternative to aminoglycosides in non-neutropenic patients.

Monitoring:

Clinical laboratory monitoring of this drug is not considered necessary as aztreonam has shown no serious toxicities. It appears to be useful in penicillin-sensitive patients.

Intramuscular therapy is a viable alternative with Aztreonam.