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[Preclinical and clinical studies on aztreonam in pediatric surgery]
H Shimomura1, T Miyano, K Kimura
1Department of Pediatric Surgery, Juntendo University School of Medicine.
Insights
Aztreonam (AZT) achieved sufficient infant serum levels for treating biliary atresia and Gram-negative infections. Studies found AZT effective and safe in infants, with prophylactic benefits in some cases.
Area of Science:
- Pediatric Pharmacology
- Infectious Diseases
- Clinical Pharmacy
Background:
- Aztreonam (AZT) is a monobactam antibiotic with activity against Gram-negative bacteria.
- Clinical studies evaluated AZT pharmacokinetics, efficacy, and safety in immature infants, neonates, and infants.
Observation:
- Pharmacokinetic analysis in infants with biliary atresia showed adequate serum concentrations after intravenous drip infusion (40 mg/kg).
- The elimination half-life (T1/2) averaged approximately 1 hour, with urinary recovery rates between 35.2% and 61.3%.
- Biliary recovery rates were minimal, ranging from 0.03% to 0.4%.
Findings:
- Aztreonam demonstrated prophylactic effects in 3 out of 5 cases.
- In treating four infection cases, AZT showed excellent efficacy in two, effective in one, and somewhat effective in one.
- No adverse side effects or abnormal laboratory values were reported in the nine infants who received AZT.
Implications:
- Aztreonam is a potentially safe and effective therapeutic option for Gram-negative infections in pediatric populations, including neonates and infants.
- The pharmacokinetic profile supports its use in infants, even those with biliary atresia.
- Further investigation into its prophylactic role may be warranted.
Abstract:
Aztreonam (AZT) was administered to immature infants, neonates and infants for preclinical and clinical studies. 1. Sufficient serum concentrations were obtained upon 1-hour intravenous drip infusion of AZT 40 mg/kg to infants with biliary atresia. The average T1/2 was about 1 hour and urinary recovery rates were in a range between 35.2 and 61.3%. Biliary recovery rates were 0.03-0.4%. 2. AZT was given to 5 cases for prophylaxis and the results showed its prophylactic effect in 3 cases. 3. AZT is effective against Gram-negative bacteria and its efficacies in the treatment of 4 infection-cases were "excellent" in 2 cases and "effective" and "somewhat effective" in 1 case each. 4. Neither side effects nor abnormal laboratory test values were observed in any of the 9 cases given AZT.