Aztreonam is the first synthetic monobactam to undergo clinical studies in the U.S. Aztreonam has excellent activity against P. aeruginosa and Enterobacteriaceae, but poor activity against anaerobic and gram-positive organisms. Aztreonam has poor oral bioavailability, but can be given intramuscularly or intravenously in doses of 1–2 g q6–12h. Clinical trials of aztreonam have shown it to be effective in infections of urine, lung, skin, blood, bones and joints, and abdomen with an adverse reaction profile similar to β-lactams. Aztreonam may be an alternate to aminoglycoside therapy, with the advantage of not being nephrotoxic.
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