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Aztreonam: clinical pharmacology
1Miller Children's Hospital, Long Beach, CA.
The Pediatric Infectious Disease Journal
|September 1, 1989
Summary
Aztreonam, a unique monocyclic beta-lactam antibiotic, offers effective treatment for Gram-negative bacterial infections in children. Its pharmacologic and pharmacokinetic profile supports its use as an alternative therapy.
Area of Science:
- Pharmacology
- Microbiology
- Pediatrics
Background:
- Monocyclic beta-lactam antibiotics (monobactams) differ structurally from traditional bicyclic beta-lactams.
- Aztreonam is the first clinically available monobactam.
Purpose of the Study:
- To evaluate the pharmacologic and pharmacokinetic profile of aztreonam in pediatric patients.
- To determine aztreonam's efficacy against aerobic Gram-negative bacteria.
Main Methods:
- Review of existing studies on aztreonam's dosing, serum concentrations, and excretion.
- Analysis of drug distribution in body fluids, including cerebrospinal fluid.
- Assessment of pharmacokinetic data in specific populations like cystic fibrosis patients.
Main Results:
- Intramuscular or intravenous aztreonam (30-50 mg/kg) maintains serum concentrations above minimum inhibitory concentrations for up to 8 hours.
- Every-6-hour dosing is effective against Pseudomonas aeruginosa; longer intervals may be suitable for low birth weight infants.
- Aztreonam is primarily renally excreted (80%), with clearance varying by postnatal age. Urinary concentrations are high and prolonged.
- Cerebrospinal fluid concentrations reach 17-33% of serum values during meningeal inflammation.
Conclusions:
- Aztreonam demonstrates a favorable pharmacologic and pharmacokinetic profile in pediatric patients.
- It may serve as a suitable alternative to traditional therapies for serious Gram-negative aerobic infections in infants and children.