Aztreonam
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Aztreonam
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| Systematic (IUPAC) name | |
| 3-[2-(2-azaniumyl-1,3-thiazol-4-yl)-2-(1-hydroxy-2- methyl-1-oxo-propan-2-yl)oxyimino- acetyl]amino-2-methyl-4-oxo-azetidine-1-sulfonate |
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| Identifiers | |
| CAS number | |
| ATC code | J01 |
| PubChem | |
| DrugBank | |
| Chemical data | |
| Formula | C13H17N5O8S2 |
| Mol. mass | 435.435 g/mol |
| Pharmacokinetic data | |
| Bioavailability | 100% (IM) |
| Protein binding | 56% |
| Metabolism | hepatic (minor %) |
| Half life | 1.7 hours |
| Excretion | Renal |
| Therapeutic considerations | |
| Pregnancy cat. | |
| Legal status |
℞-only (U.S.) |
| Routes | Intravenous and intramuscular |
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.
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[edit] 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.
[edit] 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, and Serratia species.[2]
[edit] Administration
Aztreonam must be administered intravenously, as the compound is poorly absorbed when given via the oral route.
[edit] 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.[1]
Aztreonam is considered Pregnancy category B.
[edit] References
[edit] External link
Macrolides: Azithromycin, Clarithromycin, Dirithromycin, Erythromycin, Roxithromycin
Others: Monobactams (Aztreonam), Teicoplanin, Vancomycin
