Aztreonam (injection): Difference between revisions

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{{drugbox
__NOTOC__
| IUPAC_name = 3-[2-(2-azaniumyl-1,3-thiazol-4-yl)-2-(1-hydroxy-2-<br>methyl-1-oxo-propan-2-yl)oxyimino- acetyl]amino-2-methyl-4-oxo-azetidine-1-sulfonate
{{XXXXX}}
| image = Aztreonam structure.svg
{{CMG}}; {{AE}} {{chetan}}
| width = 150px
| CAS_number = 78110-38-0
| ATC_prefix = J01
| ATC_suffix = DF01
| ATC_supplemental =
| PubChem = 54116
| DrugBank = APRD00815
| C = 13 |H = 17 |N = 5 |O = 8 |S = 2
| molecular_weight = 435.435 [[Gram|g]]/[[Mole (unit)|mol]]
| bioavailability = 100% ([[Intramuscular injection|IM]])
| protein_bound = 56%
| metabolism = hepatic (minor %)
| elimination_half-life = 1.7 hours
| excretion = [[Kidney|Renal]]
| pregnancy_category = B1 <small>([[Australia|Au]])</small>, B <small>([[United States|U.S.]])</small>
| legal_status = ℞-only <small>(U.S.)</small>
| routes_of_administration = [[Intravenous therapy|Intravenous]] and [[Intramuscular injection|intramuscular]]
}}
{{SI}}


==Overview==
''Aztreonam''' (Azactam®) is a synthetic monocyclic [[beta-lactam]] [[antibiotic]] (a ''[[monobactam]]'') originally isolated from ''[[Chromobacterium violaceum]]''.  It was approved by the [[FDA]] in 1986. It is resistant to some [[beta-lactamase]]s, but is inactivated by extended-spectrum [[beta-lactamase]]s.
==Category==
Monobactam
==US Brand Names==
AZACTAM<sup>®</sup>
==FDA Package Insert==


'''Aztreonam''' (Azactam®) is a synthetic monocyclic [[beta-lactam]] [[antibiotic]] (a ''[[monobactam]]'') originally isolated from ''[[Chromobacterium violaceum]]''.  It was approved by the [[FDA]] in 1986. It is resistant to some [[beta-lactamase]]s, but is inactivated by extended-spectrum [[beta-lactamase]]s.
''' [[XXXXX description|Description]]'''
'''| [[XXXXX clinical pharmacology|Clinical Pharmacology]]'''
'''| [[XXXXX microbiology|Microbiology]]'''
'''| [[XXXXX indications and usage|Indications and Usage]]'''
'''| [[XXXXX contraindications|Contraindications]]'''
'''| [[XXXXX warnings and precautions|Warnings and Precautions]]'''
'''| [[XXXXX adverse reactions|Adverse Reactions]]'''
'''| [[XXXXX drug interactions|Drug Interactions]]'''
'''| [[XXXXX overdosage|Overdosage]]'''
'''| [[XXXXX clinical studies|Clinical Studies]]'''
'''| [[XXXXX dosage and administration|Dosage and Administration]]'''
'''| [[XXXXX how supplied|How Supplied]]'''
'''| [[XXXXX labels and packages|Labels and Packages]]'''


== Mechanism of action ==  
==Mechanism of Action==
Aztreonam is similar in action to penicillin. It inhibits [[mucopeptide]] synthesis in the bacterial cell wall. It has a very high affinity for penicillin-binding protein 3 (PBP-3) and mild affinity for PBP-1a. Aztreonam binds the penicillin-binding proteins of [[gram-positive]] and [[anaerobic]] bacteria very poorly and is largely ineffective against them.<ref name=AHFS>{{ cite book | title= AHFS DRUG INFORMATION® 2006 | publisher= American Society of Health-System Pharmacists | date= 2006 | edition= 2006 ed }} </ref> Aztreonam is bactericidal but less so than some of the [[cephalosporins]].
Aztreonam is similar in action to penicillin. It inhibits [[mucopeptide]] synthesis in the bacterial cell wall. It has a very high affinity for penicillin-binding protein 3 (PBP-3) and mild affinity for PBP-1a. Aztreonam binds the penicillin-binding proteins of [[gram-positive]] and [[anaerobic]] bacteria very poorly and is largely ineffective against them.<ref name=AHFS>{{ cite book | title= AHFS DRUG INFORMATION® 2006 | publisher= American Society of Health-System Pharmacists | date= 2006 | edition= 2006 ed }} </ref> Aztreonam is bactericidal but less so than some of the [[cephalosporins]].


== Indications ==
Aztreonam has strong activity against susceptible [[gram-negative]] [[bacteria]], including ''[[Pseudomonas aeruginosa]]''. It has no useful activity against gram-positive bacteria or anaerobes. It is known to be effective against a wide range of bacteria including ''[[Citrobacter]]'', ''[[Enterobacter]]'', ''[[E coli]]'', ''[[Haemophilus]]'', ''[[Klebsiella]]'', ''[[Proteus (bacterium)|Proteus]]'', and ''[[Serratia]]'' species.<ref name=Mosby> {{ cite book | title=Mosby's Drug Consult 2006 | publisher= Mosby, Inc. | date= 2006 | edition= 16 ed}} </ref>


== Administration ==
Aztreonam must be administered [[intravenous]]ly, as the compound is poorly absorbed when given via the oral route.  [[Phase III]] trials are currently in progress to measure its delivery in [[nebulizer|inhaled]] form, using an ultrasonic nebulizer.


== Common adverse effects ==
Reported side-effects include injection site reactions, [[rash]], and rarely [[toxic epidermal necrolysis]]. Gastrointestinal side effects generally include [[diarrhea]] and [[nausea]] and [[vomiting]]. There may be drug-induced [[eosinophilia]]. There is limited cross-reactivity between aztreonam and other beta-lactam antibiotics, and it is generally considered safe to admininister aztreonam to patients with hypersensitivity (allergies) to penicillins.<ref name=AHFS/>


Aztreonam is considered Pregnancy category B.


== References ==
<div class="references-small" ><references/></div>
<br style="clear: both;" />


==External link==
* {{MedlinePlusDrugInfo|uspdi|202078}}




{{CephalosporinAntiBiotics}}
==References==
{{Reflist|2}}


[[Category:Monobactam antibiotics]]
[[Category:Antibiotics]]
[[Category:Thiazoles]]
[[Category:Wikinfect]]
 
[[es:Aztreonam]]
[[fr:Aztréonam]]
[[pl:Aztreonam]]
[[pt:Aztreonam]]
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{{WS}}

Revision as of 23:38, 8 January 2014


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Chetan Lokhande, M.B.B.S [2]

Overview

Aztreonam' (Azactam®) is a synthetic monocyclic beta-lactam antibiotic (a monobactam) originally isolated from Chromobacterium violaceum. It was approved by the FDA in 1986. It is resistant to some beta-lactamases, but is inactivated by extended-spectrum beta-lactamases.

Category

Monobactam

US Brand Names

AZACTAM®

FDA Package Insert

Description | Clinical Pharmacology | Microbiology | Indications and Usage | Contraindications | Warnings and Precautions | Adverse Reactions | Drug Interactions | Overdosage | Clinical Studies | Dosage and Administration | How Supplied | Labels and Packages

Mechanism of Action

Aztreonam is similar in action to penicillin. It inhibits mucopeptide synthesis in the bacterial cell wall. It has a very high affinity for penicillin-binding protein 3 (PBP-3) and mild affinity for PBP-1a. Aztreonam binds the penicillin-binding proteins of gram-positive and anaerobic bacteria very poorly and is largely ineffective against them.[1] Aztreonam is bactericidal but less so than some of the cephalosporins.





References

  1. ↑ AHFS DRUG INFORMATION® 2006 (2006 ed ed.). American Society of Health-System Pharmacists. 2006.
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