Aztreonam concentration in abdominal tissues and bile

Area of Science:

• Pharmacokinetics and Drug Metabolism
• Surgical Infectious Diseases
• Antimicrobial Chemotherapy

Background:

• Aztreonam is a monobactam antibiotic primarily used for Gram-negative bacterial infections.
• Understanding aztreonam penetration into surgical sites is crucial for effective treatment.
• Enterobacteriaceae are common pathogens in abdominal infections.

Purpose of the Study:

• To determine aztreonam concentrations in abdominal tissues, serum, and bile.
• To assess the duration of effective antimicrobial activity against Enterobacteriaceae in these compartments.
• To evaluate the pharmacokinetic profile of aztreonam in surgical patients.

Main Methods:

• 37 patients undergoing elective abdominal surgery received a 2-g intravenous aztreonam infusion.
• Abdominal tissue, serum, and bile samples were collected at intervals from 0 to 6 hours post-dose.
• Aztreonam concentrations were measured and compared to minimum inhibitory concentrations (MICs).

Main Results:

• Mean aztreonam concentrations in abdominal tissues and bile were reported.
• Specimen/serum ratios were calculated to assess tissue penetration.
• Achieved concentrations in tissue and bile exceeded MIC90 for most Enterobacteriaceae for up to 6 hours.

Conclusions:

• Intravenous aztreonam provides adequate concentrations in abdominal tissues and bile for treating Enterobacteriaceae infections.
• The drug's efficacy is sustained for at least 6 hours in these surgical sites.
• Aztreonam is a viable option for perioperative prophylaxis and treatment in abdominal surgery.