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PubMed1987

[Susceptibility of clinical bacterial isolates to aztreonam].

In vitro activities of 7 antimicrobial agents against organisms (474 strains) isolated from patients with various infections in Ehime University Hospital from May to July 1986 were investigated. Summarized results are as follows: 1. Aztreonam (AZT) showed potent activities against Escherichia coli, Citrobacter sp., Klebsiella pneumoniae, Serratia marcescens, Proteus sp., Pseudomonas aeruginosa and Haemophilus influenzae. 2. Antimicrobial activities of AZT were especially superior against Proteus sp. to the third generation cephem antibiotics. 3. Enterobacter sp. seemed more susceptible to AZT than to cephem antibiotics, but minimum inhibitory concentrations of AZT against may isolates of Enterobacter sp. were in wide ranges.

Aztreonam↗

PubMed1988

[Clinical evaluation of aztreonam against pediatric purulent meningitis].

A monotherapy of aztreonam (AZT) was applied to 9 male and 3 female pediatric patients of ages ranging from 2 months to 8 years and 11 months with serious purulent meningitis. The results are summarized as follows: 1. Daily dosages of 134 to 400 mg/kg were given 3 to 4 times a day for 10 to 28 days. 2. The isolated pathogens were Neisseria meningitidis in 2 cases, Escherichia coli in 3 cases, Haemophilus influenzae in 6 cases, but the pathogen of the last case was unknown. In this case, the patient had myelomeningocele and suffered from recurrent purulent meningitis. 3. Clinical effect was "excellent" in 5 of 12 cases, "good" in 7 cases and efficacy rate was 100%. Microbiological tests were performed on 9 cases during the course of treatment and bacterial elimination rate was 100%. All the pathogens were eliminated in 72 hours. 4. One case of diarrhea was observed, but the diarrhea started before the administration of AZT and was stopped after the AZT treatment. A slight elevation of GOT value was observed in 1 case but the value returned to the initial level promptly after the treatment was completed. It is considered that AZT is highly useful for purulent meningitis caused by Gram-negative pathogens such as H. influenzae, E. coli and N. meningitidis.

Age Factors↗

PubMed1988

[Susceptibility of clinically isolated strains to aztreonam].

In vitro antibacterial activities of aztreonam (AZT) and cephems against clinically isolated 334 strains were investigated. The results obtained in the study are summarized as follows: 1. AZT showed excellent antibacterial activities against clinically isolated 334 strains. 2. AZT showed potent activities against Escherichia coli, Klebsiella pneumoniae, Proteus spp., Enterobacter aerogenes and Citrobacter freundii. 3. Antibacterial activities of AZT were superior against Enterobacter cloacae, Serratia marcescens and Pseudomonas aeruginosa to those of cephems.

Aztreonam↗

PubMed1987

[Effects of beta-lactamases on the antibacterial activity of carumonam and aztreonam against Klebsiella sp. in comparison with 4 other beta-lactams].

Carumonam and aztreonam are two similar monocyclic beta lactam antibiotics. We have studied their antibacterial activities on Klebsiella, in comparison with cefotaxime, cefoxitin, cefotetan and imipenem. In the case of K. pneumoniae (53 strains) the antibacterial activities of the two monobactams are very similar. On the contrary, with K. oxytoca (22 strains) carumonam is significantly more active. This situation seems to be justified by an improved stability of carumonam to beta lactamases. In addition, the antibacterial activities of imipenem and of cephamycins remain quite constant within all the strains. Then the antibacterial activity of cefotaxime is fluctuant, which is in relation with a clear susceptibility to the Klebsiella beta lactamases.

Anti-Bacterial Agents↗

PubMed1987

A comparative study of cefoxitin, cefotaxime, moxalactam and aztreonam kinetics in saliva.

In immunocompromised patients with serious gram-negative aerobic infections of the oral cavity, it is necessary to treat with antibiotics that possess a broad spectrum of activity and that display satisfactory kinetic properties. The purpose of the present study was to determine the serum and salivary pharmacokinetics of four new beta-lactam antibiotics: cefoxitin, cefotaxime, moxalactam and aztreonam. A total of 20 adult surgical in-patients (14 males and 6 females) were randomly assigned treatment by one of the four antibiotics. Each antibiotic was administered IV at a dose of 2 g IV every 8 hours. Serum and saliva levels were measured by the agar diffusion method .5, 2, 4, 6 and 8 hours after the third dose. The salivary concentrations of the four antibiotics were low, but, with the exception of cefoxitin, would be adequate to treat most infections of the oral cavity caused by enterobacteriaceae. No correlation was found between the antibiotic levels in the serum and the levels in the saliva.

Aztreonam↗

PubMed1987

[Susceptibility of clinical isolates to aztreonam].

Aztreonam (AZT), which has a newly developed and synthetic structure belonging to the group of monobactams, possesses excellent antibacterial activity against a broad range of Gram-negative bacteria (including the beta-lactamase producing strains). Antibacterial activities of AZT were examined and compared with those of 5 antibiotics (cefoperazone (CPZ), latamoxef (LMOX), cefotaxime (CTX), cefmetazole (CMZ) and cefsulodin (CFS) against 296 strains of clinical isolates. The evaluation of antibacterial activities was determined with the inhibition zone diameter obtained by the single disc method. The results can be summarized by three categories as follows: 1. Susceptibility of clinical isolates to AZT and other antibiotics AZT and other 3rd-generation antibiotics (CPZ, LMOX, CTX) showed excellent antibacterial activities against most strains. Especially AZT was more active against Enterobacter cloacae and Serratia marcescens than reference drugs. Against Pseudomonas aeruginosa, the activity of AZT was similar to that of CFS. AZT showed as excellent activity against P. aeruginosa as CFS. 2. Susceptibility of strains isolated from different clinical materials and different clinics AZT showed the highest antibacterial activity against the clinical isolates from sputum, pharynx, urine, pus, bile, puncture fluid, blood and others. AZT exhibited the most potent activity against isolates in the 7 clinics we tested. 3. Susceptibility of strains isolated from inpatients and outpatients AZT demonstrated the highest antibacterial activity (the rate of susceptibility: 87.0%) against strains obtained from inpatients (except for P. aeruginosa). The activity of AZT (81.4%) against P. aeruginosa was as active as that of CFS (81.4%), and it was the highest in all drugs. Antibacterial activity of these antibiotics against bacteria was rated as follows: AZT greater than LMOX greater than CPZ greater than CTX greater than CMZ AZT showed the highest antibacterial activity (100%) against strains isolated in all the materials and at all the clinics tested of outpatients. Antibacterial activity of these antibiotics against isolates from outpatients was rated as follows: AZT greater than CPZ greater than LMOX greater than CTX greater than CMZ.

Aztreonam↗

PubMed1986

[Efficacy evaluation of aztreonam for suppurative otitis media].

Preclinical and clinical studies were performed to evaluate usefulness and safety of aztreonam (AZT) in the treatment of acute otitis media, acute exacerbation of chronic otitis media and chronic otitis media and the following results were obtained. MICs for P. aeruginosa, P. mirabilis and P. inconstans isolated from the patients with suppurative otitis media were 1.56 micrograms/ml, less than or equal to 0.025 micrograms/ml and less than or equal to 0.025 micrograms/ml respectively in their peaks. In the intravenous injection of 1 g, AZT concentration in the mastoid cell mucosa was 7.52 micrograms/g on average and serum concentration 51.6 micrograms/ml sufficiently suggesting clinical efficacy of AZT. In the clinical trial by administering AZT 1-2 g/day for the patients with suppurative otitis media, effective rates were 2/3 (66.7%) for acute otitis media, 16/22 (72.7%) for acute exacerbation of chronic otitis media, 21/34 (61.8%) for chronic otitis media and 6/7 (85.7%) for cholesteatoma of the middle ear. Elimination rate of single Gram-negative pathogens was 82.1% in the bacteriological studies of AZT. As for abnormal laboratory findings, 7 cases showed GOT, GPT elevations. However, they were in minor degree and transient. Side effect was not noted except 1 case of flushing with itching. It was considered from the above results that AZT is a highly useful antibiotic for suppurative otitis media.

Adult↗

PubMed1986

[Well-controlled comparative study on aztreonam and cefoperazone in the treatment of complicated urinary tract infections].

A well-controlled comparative study was conducted in order to evaluate the efficacy, safety and usefulness of the monobactam antibiotic aztreonam (AZT) in complicated urinary tract infections (UTI) using cefoperazone (CPZ) as the control drug. Patients with complicated UTI due to Gram-negative bacteria were examined. However, in polymicrobial infections, the cases caused by Gram-negative and Gram-positive bacteria were also examined. Both drugs were administered 1 g, twice a day by intravenous drip infusion for 5 days. Overall clinical efficacy was evaluated by the criteria proposed by the UTI committee in Japan. Of the total 394 cases, the clinical efficacy was evaluated for 152 cases in the AZT group and 143 cases in the CPZ group excluding 99 cases of exclusion or dropout. There was no statistically significant difference in the back ground characteristics between the 2 groups. The overall clinical efficacy rate was 55.3% for AZT and 55.2% for CPZ with difference not significant. As for clinical efficacy, in the monomicrobial infection after postprostatectomy (G-2), AZT was superior to CPZ (P less than 0.05), whereas in the polymicrobial infection without indwelling catheter (G-6), CPZ was superior to AZT (P less than 0.1). The overall bacteriological eradication rate was 77.2% for AZT and 74.5% for CPZ. For Gram-negative bacteria only the eradication rate for AZT (83.2%) was superior to that for CPZ (74.6%). This was probably due to the stability of AZT to beta-lactamase. Side effects were observed in 3 cases out of 201 in the AZT group and 5 cases out of 189 in the CPZ group. No severe abnormal laboratory finding was observed in any group; there was no significant difference between the 2 groups. Consequently, AZT was judged to be an antibiotic with clinical usefulness equal to, or even superior to that of CPZ.

Adolescent↗

PubMed1986

Morphological studies of Escherichia coli in the urine of patients with acute simple cystitis treated with aztreonam.

The effects of aztreonam (AZT) on the morphology of Escherichia coli in the urine of 5 patients with acute simple cystitis were studied by differential interference contrast microscopy. The urine specimens were collected via catheter before, 5, 15 and 30 minutes after intravenous administration of 1.0 gm AZT. The minimum inhibitory concentration of E. coli against AZT was 0.05 microgram/ml. The mean urinary concentrations at 5, 15 and 30 minutes after administration of AZT were 481.6 micrograms/ml, 1168.2 micrograms/ml and 993.4 micrograms/ml, respectively. In 4 patients, the urinalysis became normal within 30 minutes after the administration. Filamentous cells were observed at low and high urinary concentrations of AZT. They had vacuole-like formations. These findings were characteristic morphological changes caused by AZT. In the other patient, spheroplasts and ovoid cells were observed. AZT in the urine of patients with acute simple cystitis is suggested to have a high affinity for penicillin-binding protein (PBP) 3 and moderate affinity for PBP 1a.

Acute Disease↗

PubMed1986

Effects of aztreonam and netilmicin upon alveolar macrophage function.

Both aztreonam and netilmicin showed no toxic effect on alveolar macrophage function when administered at varying concentrations. Killing ability was unchanged as well. The increase of enzyme delivery, assessed at varying concentrations, was very limited and of no relevance in the pathogenesis of possible tissue damage. It can be explained on the basis of a change in the permeability of membranes or to output during phagocytosis. In cultures containing either antibiotic under similar conditions we did not note any substantial differences. The concentrations tested can be used safely in the therapy of infections due to most gram-negative bacteria.

Acid Phosphatase↗

PubMed1986

Treatment of infections during hematologic malignancies with aztreonam, a new antibiotic.

Nineteen patients with hematological malignancies (5 malignant lymphomas, 9 acute leukemia and 5 other hematological diseases) were treated with aztreonam alone or in combination for infection. Four out of five patients in the lymphoma group, 6/9 in the leukemia group and 4/5 in the last group were considered cured of their infection. No important clinical side effects or consistent deterioration of hematology and chemistry tests were observed.

Acute Disease↗

PubMed1986

[Pharmacokinetic studies on aztreonam in late pregnancy in sheep and humans].

The transplacental passage of single intravenous doses of aztreonam (AZT), 1 g or 2 g, was examined in 7 sheep and 14 women in late pregnancy, respectively and the obtained data were analyzed by a two-compartment model. The obtained results were summarized as follows. After single 2 g intravenous doses were given to pregnant sheep, the mean peak level of AZT in maternal blood was 83.79 micrograms/ml and the half-life of the beta-phase was 1.525 hours. After single 1 g intravenous doses were administered to pregnant women, the mean peak level of AZT in blood was 102.62 micrograms/ml and the half-life of beta-phase was 2.128 hours. The peak levels in umbilical venous blood and amniotic fluid were 14.43 micrograms/ml and 11.86 micrograms/ml, respectively.

Amniotic Fluid↗

PubMed1986

[Studies of aztreonam transfer into the fetus and amniotic fluid in early pregnancy].

The materno-fetal transfer of aztreonam by a single intravenous dose of 1 g was examined in 7 volunteer women undergoing induced abortion in early pregnancy and the following results were obtained. After administration of the drug, maternal blood levels at 15, 30, 60 and 120 minutes were 77.24 +/- 6.09 micrograms/ml (Mean +/- S.E.), 37.84 +/- 5.85 micrograms/ml, 25.62 +/- 3.15 micrograms/ml and 18.10 +/- 2.22 micrograms/ml, respectively. Amniotic fluid level of the drug was low in 3 cases, of which amniotic fluid levels were determined; 0.74 microgram/ml after 229 minutes, 0.83 microgram/ml after 280 minutes and 0.74 microgram/ml after 328 minutes. Fetal tissue concentration of the drug was below our detection limit at 120 minutes. Tissue levels of villus and decidua in 6 cases were also too low to be detectable between 89 and 328 minutes after injection.

Adult↗

PubMed1985

[Fundamental and clinical studies on aztreonam in obstetrics and gynecology].

Aztreonam (AZT), a monobactam antibiotic, is known to have a high activity against Gram-negative bacteria. Fundamental and clinical studies were carried out on AZT with the following results. Following 1 g of bolus intravenous injection, the transfer of AZT to uterine artery and internal genital organs was found to be satisfactory. The levels of the drug in uterine artery showed 34.28, 4.50 micrograms/ml at approximately 2, 6 hours, and those in internal genital organs showed 3-34 micrograms/g at 2 hours. Clinical efficacy was; excellent in 4 cases, good in 13 cases and poor in 1 case, with the very high overall efficacy rate of 94.4%. Abnormal laboratory findings and side effects due to the drug were not noted.

Adolescent↗

PubMed1985

[Preclinical and clinical studies on aztreonam in obstetrics and gynecology].

Aztreonam (AZT), a new monobactam antibiotic, was studied in obstetrics and gynecology with the following results. The tissue concentration of AZT in the female genital organs was relatively high at the portio vaginalis and the cervix uteri followed by at the ovary and the myometrium, but the distribution to the endometrium and the oviduct was a little poor. The concentration of AZT in the pelvic dead space exudate was highest at 2 hours after intravenous injection whereas it was highest at 5 hours after intravenous drip infusion. However, there was no significant difference in the concentration between intravenous injection and intravenous drip infusion and the distribution to the pelvic dead space exudate was relatively good. AZT was clinically administered to pyometra (3 cases), puerperal endometritis (3), adnexitis and endometritis (3), pelvioperitonitis (1), Bartholin's abscess (4) and purulent vulvitis (1), a total of 15 cases with an overall effective rate of 93.3%. AZT was microbiologically effective for Gram-negative bacteria such as E. coli and K. pneumoniae, but also effective for anaerobes and some Gram-positive bacteria, etc., for which MIC of AZT is high. With regard to safety of AZT, neither side effects nor abnormal laboratory findings were reported.

Adult↗

PubMed1985

[Clinical effect of aztreonam in infections in obstetrics and gynecology].

Aztreonam (SQ 26,776, AZT), a new monobactam antibiotic, was studied in obstetrics and gynecology with the following results. For the study of tissue penetration, 1 g AZT was administered by intravenous drip infusion for 1 hour. The concentration was high in elbow venous blood and uterine arterial blood 60 minutes after the administration. Each uterine tissue concentration other than the endometrium was as high as 26.7-31.7% of the blood level and salpinx and ovary concentration were 25.9% and 5.2%, respectively. Each tissue concentration decreased to less than 0.6 microgram/g in the uterine, the ovary and the salpinx 280 minutes thereafter. In the review of obstetric and gynecologic genital infections, clinical efficacy of AZT was "poor" for 1-endometritis, "poor" for 1-pyometra, "excellent" for 1-puerperal fever, "excellent" (1) and "good" (2) for 3-pelvioperitonitis, "excellent" for 1-parametritis and "good" for 2-infectious lymphocele with overall effective rate of 77.8% (7/9). AZT was microbiologically effective for Gram-negative bacteria, such as E. coli, K. pneumoniae, etc. As for safety, neither side effects nor abnormal laboratory findings in the examination of blood, hepatic function, renal function and urine due to AZT were reported.

Adult↗

PubMed1985

[Clinical efficacy of aztreonam in pelvic peritonitis].

Aztreonam (AZT) was evaluated for its clinical efficacy in 6 patients with pelvic peritonitis. In all the cases, AZT was administered by intravenous injection, and the duration of treatment ranged from 4 to 12 days. Daily dose was 2 g in 4 cases, and 4 g in the remaining 2 cases. Surgical treatment was necessary in 2 cases, whereas in another 2 cases, either LMOX or ABPC was administered in addition to AZT. The clinical results was excellent or good in 5 out of 6 cases. Side effects possibly attributed to AZT were diarrhea in 2 cases and slight increase of GOT and GPT in 1 case, although they disappeared promptly afterward.

Adult↗

PubMed1985

[Clinical studies on aztreonam in various infections in obstetrics and gynecology].

Aztreonam (AZT) was administered to 10 patients with obstetric and gynecologic infections to evaluate its clinical effect. Two-four grams of AZT per day (b.i.d.) were administered for the treatment for 4-15 days by intravenous drip infusion or intravenous injection. AZT was effective for 3 cases of pelvic peritonitis, 1 case of pyoovarium and 2 cases of Bartholin's abscess. For 2 cases of intrauterine infection, AZT was effective for 1 case, and the other case could not be judged. For 2 cases of local infection, AZT was effective for 1 case and ineffective for 1 case. Efficacy rate was 89% for the 9 cases excluding the 1 unevaluable case. Microbiological effect was determined for 4 out of 10 cases. Two strains of Haemophilus influenzae and one each of Escherichia coli, Bacteroides fragilis and Streptococcus intermedius were isolated, but all of them were eliminated for a elimination rate of 100%. Neither abnormal laboratory findings in hepatic or renal functions, etc. nor side effects were recognized.

Adult↗