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Nephrotoxicity and ototoxicity of aztreonam versus aminoglycoside therapy in seriously ill nonneutropenic patients.
- Source :
-
The Journal of infectious diseases [J Infect Dis] 1992 Apr; Vol. 165 (4), pp. 683-8. - Publication Year :
- 1992
-
Abstract
- A randomized double-blind clinical trial was done of aztreonam versus aminoglycoside therapy for the empiric treatment of seriously ill nonneutropenic patients suspected of aerobic gram-negative bacterial infection. Each patient was treated for greater than or equal to 72 h with the study drug. Nephrotoxicity, defined by greater than or equal to 50% increase in baseline serum creatinine, occurred in 12 (15%) of 92 patients receiving aminoglycoside therapy and 1 (1%) of 92 patients receiving aztreonam (P less than .004). More severe nephrotoxicity, defined by greater than or equal to 100% increase in baseline serum creatinine, occurred in 6 (6.5%) of 92 patients receiving aminoglycoside therapy and in 1 of 92 receiving aztreonam (P less than .11). Patients with an elevated baseline total bilirubin level were most likely to develop nephrotoxicity. Auditory toxicity occurred in 2 (7%) of 28 evaluatable patients receiving aminoglycoside therapy and in 1 (3%) of 33 receiving aztreonam (P less than .58). One patient, who received aminoglycoside, developed vestibular toxicity. In nonneutropenic patients believed to be at increased risk for renal dysfunction, aztreonam is a less toxic alternative to aminoglycoside therapy for treatment of suspected aerobic gram-negative infection.
- Subjects :
- Aminoglycosides
Anti-Bacterial Agents therapeutic use
Aztreonam therapeutic use
Bilirubin blood
Creatinine blood
Double-Blind Method
Female
Humans
Male
Middle Aged
Regression Analysis
Risk Factors
Vestibule, Labyrinth drug effects
Anti-Bacterial Agents adverse effects
Auditory Threshold drug effects
Aztreonam adverse effects
Gram-Negative Bacterial Infections drug therapy
Kidney drug effects
Subjects
Details
- Language :
- English
- ISSN :
- 0022-1899
- Volume :
- 165
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- The Journal of infectious diseases
- Publication Type :
- Academic Journal
- Accession number :
- 1552197
- Full Text :
- https://doi.org/10.1093/infdis/165.4.683