SEARCH · PubMed Health

Results for “Aztreonam”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 307 records · Page 17Linked to original sources

PubMedDate not supplied

[Prophylaxis in prostatic surgery with aztreonam. Our experience].

Aztreonam is a monobactam antibiotic with a very specific spectrum of action for gram-negative aerobic bacteria. Since these bacteria are responsible for most of the urinary tract infections, we conducted a study to determine its efficacy in the prophylaxis and treatment of infections in prostate surgery, one of the most common procedures performed in our field. Thirty-two patients received 1 gm Aztreonam at the time of anesthetic induction and q 8 h thereafter to a total dose of 3 gm. Cultures were performed before and 72 h after surgery. Twenty-eight patients had no complications and a sterile urine culture or less than 10,000 colonies, 2 developed wound infection from Staph, aureus and 1 had more than 100,000 colonies of Enterococci in urine. The foregoing findings indicate that Aztreonam is useful for prophylaxis and treatment of urinary tract infections in prostate surgery.

Aged↗

PubMed1992

Aminoglycosides, imipenem, and aztreonam.

The aminoglycosides continue to be the cornerstone of antibiotic therapy for serious infections caused by gram-negative aerobic pathogens, even with the recent introduction of potent beta-lactams and the fluoroquinolones. Two of these newer agents are imipenem and aztreonam. Imipenem is the most expensive commercially available antibiotic, but it has the broadest range of activity, including most gram-negative and gram-positive, aerobic and anaerobic bacteria. Aztreonam, the first monobactam antibiotic to be released, has excellent activity against aerobic, gram-negative bacteria. It is not, however, simply a nonnephrotoxic replacement for aminoglycoside therapy. This article reviews the basic pharmacology and clinical utility of the aminoglycosides, imipenem, and aztreonam.

Aminoglycosides↗

PubMed1990

[In vitro activity of aztreonam, cefoperazone and ceftriaxone against gram-negative bacteria].

In this study, the in vitro activity of aztreonam was compared with that of cefoperazone and ceftriaxone against 1000 gram-negative bacilli. Among gram-negative bacteria, resistance to aztreonam, cefoperazone and ceftriaxone were noted 2.7%, 11.3%, 11.5% respectively. The results obtained in this study indicate that aztreonam is highly effective against gram-negative bacilli.

Aztreonam↗

PubMed1989

[Aztreonam vs norfloxacin: a comparative study of the treatment of urinary tract infections in ambulatory and hospitalized patients].

Eighty-two evaluable patients suffering from UTI were randomly treated with parenteral Aztreonam (1 g OD in cystitis and 1 g BID in pyelonephritis) or oral Norfloxacin (400 mg BID). Predisposing urological conditions were present in 75% and 78.5% respectively. Microbiological cultures at the end of treatment and at a follow-up visit after 4 weeks showed significantly better results among Aztreonam treated patients (microbiological cure: 97.5% vs 71.4%-p less than or equal to 0.005). Clinical cure was achieved in 97.5% and 71.4% respectively (p less than or equal to 0.001). A statistically significant difference was present only in patients treated for pyelonephritis (microbiological cure-AZT: 100%; NOR: 50%-p less than or equal to 0.0005) and not in those with cystitis (AZT: 95.0%; NOR: 83.3%). Side effects were rare in both treatments. Aztreonam seems to offer major advantages, when compared to Norfloxacin, in the treatment of UTI, especially when upper urinary tract is involved.

Administration, Oral↗

PubMedDate not supplied

Aztreonam for injection (lyophilized): development of an automated solution batching process utilizing volumetric powder feeders.

As part of a commitment to fully automate the manufacture of a lyophilized dosage form of Azactam (Aztreonam for Injection), an automated solution batching procedure was developed. The lyophilization process requires solution batching of Aztreonam and L-arginine, the two constituents of the product. To avoid preblending of aztreonam and L-arginine prior to dissolution, a batching process was developed which makes use of two separate volumetric powder feeders. In conjunction with a feedback pH control system, these powder feeders provided for (a) a faster batching process, (b) a tight control of solution pH during batching, (c) a failsafe system to prevent operator error and equipment malfunction. Data are presented correlating bulk densities of various powders with feeder output along with solution pH profiles determined using the manual mode and the automated feedback pH control system.

Automation↗

PubMed1989

Comparative multicenter study on efficacy and safety of aztreonam and gentamicin in prophylaxis of high-risk colorectal surgery.

The usefulness of antibiotic prophylaxis in reducing the incidence of postoperative infections following colorectal surgery has been defined in many clinical studies. Since a single antibiotic agent covering all the potential pathogens (i.e. Gram-negative aerobes and anaerobes) is not currently available, a combination therapy is usually administered. The present study reports the preliminary results on comparative efficacy and safety of aztreonam and gentamicin (both combined with clindamycin) as short-term prophylaxis in colorectal surgery. Four hundred and fifty-four patients, out of 495 enrolled, were considered evaluable. Incidence of abdominal wound infections was significantly lower in the aztreonam-treated group (5.8% vs 12.5% - p less than or equal to .025). The incidence of perineal wound and abdominal infections, of fever, of need for postoperative antibiotics and the length of postoperative stay were lower in the monobactam group, even if none of these differences were statistically significant. Gram-negative aerobic microorganisms were more often isolated in infected patients from the gentamicin group. Side effects were minor and similar in the two groups. From these preliminary data, the aztreonam-clindamycin combination can be considered a major candidate to replace many of the presently available oral and parenteral regimens.

Adult↗

PubMed1989

[Pseudomonas aeruginosa infection of the sternum and costal cartilages in cardiosurgery. Therapeutic experience using aztreonam].

Clinical effectiveness of Aztreonam was studied. This new monobactam antimicrobial agent was tasted in the treatment of post-operative infectious complications of cardiac surgical sternal wounds. Ten patients (4 men and 6 women, age range 20 to 68 years) were entered into the study. All had a Pseudomonas aeruginosa infection of sternum or sternum and ribs and all underwent an extensive regional surgery of the infection wound and received a topical and/or IV treatment with Aztreonam. In all cases we obtained a satisfactory result, with complete eradication of the infection. Both local and systemic tolerance to the drug were excellent and no side-effect was registered. Therefore Aztreonam can be considered an active and safe antibiotic for the treatment of sternal and/or costal postsurgical infections by Pseudomonas aeruginosa.

Adult↗

PubMed1989

Effect of aztreonam on immunohistochemical localizations of cytochrome P-450 (M-1) in male rats.

The localization of sex-specific cytochrome P-450, P-450 (M-1), was investigated immunohistochemically in the liver of untreated- and Aztreonam-treated male rats. P-450 (M-1) was uniformly distributed in the liver lobule of untreated rats. By treatment with Aztreonam, P-450 (M-1) was decreased more in the periportal region rather than the pericentral region of the lobule. In addition, oxidation of testosterone and 1 alpha-hydroxycholecalciferol catalyzed by P-450 (M-1) was also decreased by Aztreonam administration.

Animals↗

PubMed1987

[Effect of aztreonam on the fecal aerobic flora in children].

Aztreonam, a new monobactam, has a spectrum limited to Gram negative aerobic bacilli. To evaluate its effect after parenteral administration on aerobic stool flora (Gram negative bacilli, Streptococci D, Staphylococci, Candida), quantitative cultures used serial dilution of stools twice a week on selective media. For Gram negative bacilli, agar dishes containing aztreonam or not were used. Colonies of different morphologies were counted. Representatives of each morphological type were then picked for identification and susceptibility tests. Among the 16 patients treated, 12 were decontaminated for aerobic gram negative bacilli by the 3rd day. Sensitive bacteria persisted in 4 cases, although at a low level. Resistant bacteria (Enterobacter cloacae and Acinetobacter) appeared at a "normal" level in 2 patients initially decontaminated. No dramatic change could be detected for Streptococci D, Staphylococci and Candida. In twelve additional infants neither hospitalized nor treated, no aztreonam resistant Gram negative bacilli could be found.

Adolescent↗

PubMed1988

Role of aztreonam in urinary tract infections.

Bacterial colonization is the necessary first step in the etiology of all urinary tract infections. The hospital setting provides a pool of pathogenic bacteria which may lead to colonization in the hospitalized patient. The nosocomial infections which may follow and require treatment most often follow catheterization. Some host factors often lead to persistence of colonization and invasive symptomatic disease. These might include stone, caliceal diverticula, a hydronephrotic kidney, vesicoureteral reflux, bladder neck obstruction with residual urine, urethral diverticula, and infection of the prostate, as well as other disease states such as diabetes mellitus, cancer, or drug immunosuppression. Bacterial virulence must also be considered, but since normal host barriers are broken down by catheterization or instrumentation, usually avirulent bacteria are the more common cause of nosocomial urinary tract infections. Increasing bacterial resistance to antibiotics has been recognized among nosocomial infections. Thus, for a stringent trial, any new drug should be used to treat infections due to bacteria with multiple antibiotic resistance. The antibiotic must be active against the organisms, and early follow-up should evaluate both microbiologic and symptomatic cure. Late follow-up should show that there is no persistence of the original organism. New antibiotics should show some advantage over present antibiotics being used for treatment. Aztreonam offers an advantage over aminoglycosides in that it is neither ototoxic nor nephrotoxic. It appears to cause less antibiotic resistance in bacteria colonizing the intestine and therefore holds an advantage over most of the beta-lactam antibiotics. In addition, aztreonam does not appear to be haptogenic and has shown little cross-allergenicity to either penicillins or cephalosporins. Worldwide trials of the drug suggest that aztreonam is as efficient, if not more so, than the third-generation cephalosporins, newer penicillin derivatives, and the aminoglycosides in the treatment of Pseudomonas and other bacteria causing nosocomial urinary tract infections.

Aztreonam↗

PubMed1988

Clinical evaluation of aztreonam for serious gram-negative bacterial infections.

In an open study aztreonam was evaluated for efficacy and safety in 20 hospital in-patients presenting with presumptive or confirmed hospital acquired aerobic gram-negative infections. The overall clinical cure rate was 100% (19/19) with a corresponding microbiological cure rate of 100% in those patients in whom an organism was isolated initially (17/17). Reinfection with enterococcus occurred in 2 patients with UTI within a week of stopping aztreonam and one patient developed superinfection during treatment, but none were given any additional therapy. No evidence of drug-associated toxicity was found on any of the laboratory evaluations. One patient developed diarrhea 3 days after starting therapy, was withdrawn from the study and subsequently excluded from the analysis. One other patient remained febrile despite evidence of clinical and microbiological cure. Both these incidents were thought to be possibility drug-related. This study confirms aztreonam as a safe and effective way to treat patients with serious gram-negative infections.

Adult↗

PubMed1986

Stability of clindamycin phosphate with aztreonam, ceftazidime sodium, ceftriaxone sodium, or piperacillin sodium in two intravenous solutions.

In admixtures containing clindamycin and either aztreonam, ceftazidime, ceftriaxone, or piperacillin in either 5% dextrose injection (D5W) or 0.9% sodium chloride injection (NS), the stability of each drug was studied. Each of the following combinations of drugs was added to 100-mL glass bottles of base solution: clindamycin phosphate 0.9 g and aztreonam 2.0 g, clindamycin phosphate 0.9 g and ceftazidime sodium 2.0 g, clindamycin phosphate 1.2 g and ceftriaxone sodium 2.0 g, and clindamycin phosphate 0.9 g and piperacillin sodium 4.0 g. Duplicate samples were prepared. Admixtures containing each single drug were also tested. Samples were visually inspected and tested for pH and drug concentration immediately after mixing and at 1, 4, 8, 12, 24, and 48 hours of storage in room temperature and light. Drug concentrations were determined by high-performance liquid chromatographic assay methods. Ceftriaxone retained greater than 90% of its original concentration for 24 hours in single-drug admixtures in NS, for eight hours with clindamycin in NS, and for one hour with clindamycin in D5W. Ceftazidime retained greater than 90% potency for 24 hours with clindamycin in D5W. In all other test admixtures, all drugs were stable for 48 hours. Under the conditions studied, clindamycin is compatible in the admixtures tested with aztreonam and piperacillin. Admixtures of clindamycin and ceftazidime in D5W should be used within 24 hours at room temperature. Clindamycin and ceftriaxone can be mixed in NS if administered within eight hours, but ceftriaxone is stable for only one hour in combination with clindamycin in D5W.

Aztreonam↗

PubMed1987

[Clinical evaluation of aztreonam in the prevention and therapy of infections in patients subjected to neurosurgical intervention].

Twenty-six neurosurgery patients were given prophylactic treatment with Aztreonam at a dose of 1 g every 8 hours (30 mg/kg every 12 hours in children) for 8-12 days after the operation. In 18 cases 300 mg Clindamycin was also given every 8 hours for 8 days. No local or general infections arose in the postoperative period. Three patients with infections caused by susceptible bacteria were given 1 g Aztreonam every 6 hours (30 mg/kg every 8 hours in children) for 8 days. In all cases all clinical and microbiological signs of the infection had disappeared by the end of treatment. Apart from one episode of mild nausea no side effects were noted. Aztreonam is therefore considered a safe and effective drug for the treatment and prophylaxis of postoperative infections in neurosurgery.

Adult↗

PubMed1986

Use of aztreonam in patients suffering from urinary tract infections with contraindications for the use of aminoglycosides.

The clinical efficacy and safety of aztreonam were studied in 30 patients suffering from urinary tract infections caused by gram-negative bacteria. Aztreonam was given in a dose of 1 g i.m. at intervals of 12 or 24 hours. Duration of therapy was 2-8 days. Bacteria isolated in urine cultures were: Escherichia coli (60%); Proteus mirabilis (10%); Pseudomonas aeruginosa and Citrobacter sp. (7%); Proteus vulgaris, Serratia marcescens; Klebsiella pneumoniae and Pseudomonas species (3%). At completion of therapy and at follow-up all patients were bacteriologically and clinically cured. No significant side effects or toxicity were observed in all patients treated. It is concluded from these data that aztreonam is highly effective and well tolerated in patients affected either by upper or lower urinary tract infections.

Adult↗

PubMed1987

Efficacy and safety of aztreonam in the treatment of serious gram-negative bacterial infections.

Aztreonam was used in the initial treatment of infection of the urinary tract (23 cases), respiratory tract (17 cases), skin and soft tissue (12 cases), abdominal cavity (three cases), endocarditis (two cases), septicemia (eight cases), and osteomyelitis (two cases). In 26 of 60 evaluable infectious episodes, aztreonam was used alone. Clinical cure was observed in 35 of 60, improvement in 24 of 60, and failure in one of 60 cases. Ten patients developed subsequent superinfection. Aztreonam was well tolerated, although one case of exfoliative dermatitis and one of pseudomembranous colitis occurred. However, these cases were complicated by proximal administration of other antibiotics.

Adult↗

PubMed1985

Aztreonam in the therapy of nosocomial infections in patients with impaired host defenses.

A clinical trial was carried out to evaluate the effectiveness of treatment with aztreonam in hospital-acquired infections. Twenty patients (13 men and 7 women) with impaired host defenses and nosocomial infections were treated with aztreonam at a dosage ranging 4 and 6 g/day I.V. at 8 or 12-hour intervals. Average length of therapy was 10.35 +/- 4.61 days. The isolated organisms were as follows: Escherichia coli (5), Pseudomonas aeruginosa (5), Klebsiella pneumoniae (3), Enterobacter cloacae (1), Proteus mirabilis (2), Proteus vulgaris (1), Acinetobacter anitratus (1), Serratia marcescens (1), Citrobacter freundii (1), Bacteroides fragilis (3), Bacteroides melaninogenicus (1). In 5 patients (25%) a mixed infection was observed. Sixteen patients (80%) were completely cured from infection and 24 isolated organisms (88.8%) were eradicated. No adverse reactions were observed. Aztreonam has undoubtedly high clinical and bacteriological efficacy in the therapy of nosocomial infections in patients with impaired host defenses.

Adult↗

PubMed1985

[Aztreonam. Diffusion into bronchial mucus].

In a prospective study of antibiotics' diffusion into human bronchial mucus, we compared serum and mucus concentrations of aztreonam, a new beta lactam belonging to the monobactam group. Twenty patients were given aztreonam (1 g twice a day) for an acute purulent exacerbation of chronic bronchitis and divided into four groups according to the time of sampling (0.5, 1, 1.5 or 3 h). Samples were taken on the first and third treatment days. Antibiotic concentrations were assayed using agar diffusion and HPLC. Aztreonam concentrations were low, similar to those achieved with other beta lactams. According to the time sampling, levels ranged from 0.27 to 1 mg/l and 0.4 to 1.15 mg/l on the first and third treatment days respectively. Corresponding serum levels were 90 mg/l and 30 mg/l, respectively 30 mn and 3 h after dose ingestion.

Aztreonam↗

PubMed1984

Effect of aztreonam on the growth of Pasteurella multocida in the lung.

Specific-pathogen-free ICR mice were infected aerogenically with Pasteurella multocida and, beginning 1 hour later, were treated with aztreonam (50 mg/kg of body weight). The number of viable bacilli in the lungs, liver, and spleen were determined at intervals for up to 36 hours. Aztreonam was bactericidal for growing bacilli in vitro and, when injected 1 and 5 hours after aerogenic exposure, provided greater than 80% protection after dosage at the level of 12.5 mg/kg. Below this dosage level, viable organisms persisted in the lungs and the spleen and many of the minimally treated mice eventually died of pasteurellosis. The survivors developed active immunity as a result of the continued sublethal infection. Aztreonam protects mice against an aerogenic infection with highly virulent P multocida and may be useful in the prevention and treatment of pasteurellosis in cattle.

Animals↗