Aztreonam is a monocyclic synthetic bactericidal beta-lactam antibiotic that has a selective spectrum of action against aerobic gram-negative bacteria and is intended for parenteral use . Isolated from a culture of Chromobacterium violaceum .
| Aztreonam | |
|---|---|
| Aztreonam | |
 | |
| Chemical compound | |
| IUPAC | [2S- [2α, 3β (Z)]] - 2 - [[[1- (2-Amino-4-thiazolyl) -2 - [(2-methyl-4-oxo-1-sulfo-3-azetidinyl) amino] -2-oxoethylidene] amino] oxy] -2-methylpropanoic acid ([2S- [2α, 3β (Z)]] - 2 - [[[1- (2-Amino-4-thiazolyl) -2- [ (2-methyl-4-oxo-1-sulfo-3-azetidinyl) amino] -2-oxoethylidene] amino] oxy] -2-methylpropanoic acid) |
| Gross formula | C 13 H 17 N 5 O 8 S 2 |
| Molar mass | 435.43 g / mol |
| Cas | |
| PubChem | |
| Drugbank | |
| ATX | |
| Pharmacokinetics | |
| Bioavailable | high |
| The half-life. | 1.7 hours |
| Excretion | kidneys : 60-70% |
| Dosage Forms | |
| powder for the preparation of an injectable solution for iv administration | |
| Route of administration | |
| intravenous inhalation | |
Description
Aztreonam belongs to the antibiotics of the monobactam group, has a narrow spectrum of action, is active mainly against certain strains of aerobic gram-negative bacteria. The drug has a pronounced bactericidal effect, leads to the death of microorganisms. The mechanism of action of aztreonam is based on its ability to bind to penicillin-binding protein 3 and inhibit the formation of peptidoglycan , which is the basis of the bacterial cell wall . Due to the violation of the integrity and structure of the cell membrane, the death of microorganisms sensitive to the action of the drug. The bactericidal properties of aztreonam are noted against Citrobacter spp. (including Citrobacter freundii), Enterobacter spp. (including Enterobacter сloacae), Escherichia coli , Klebsiella oxytoca, Klebsiella pneumoniae , Serratia species (including Serratia marcescens), as well as Proteus mirabilis and Pseudomonas aeruginosa . In addition, strains of Haemophilus influenzae are sensitive to its action, including strains producing penicillinases. There is evidence of drug efficacy in diseases caused by strains of Aeromonas hydrophila , Morganella morganii, Pasteurella multocida, Proteus vulgaris, Providencia stuartii, Providencia rettgeri, Yersinia enterocolitica, and Neisseria gonorrhoeae , including those producing Neisseria gonorrhoeae . The drug has a narrow spectrum of action and practically does not affect the microflora of the body and does not cause dysbiosis. The development of cross-resistance of aztreonam and antimicrobial agents of the aminoglycoside group was noted.
Indications for use
The drug is used to treat patients suffering from infectious diseases caused by microorganisms sensitive to the action of aztreonam, in particular:
- Infectious diseases of the lower respiratory tract: bronchitis , pneumonia , lung abscess .
- Infectious diseases of the skin and soft tissues: erysipelas , infected dermatitis .
- Infectious diseases of the kidneys and urinary tract: acute and chronic cystitis , pyelitis , pyelonephritis , prostatitis .
- Nosocomial infections caused by Pseudomonas aeruginosa .
In addition, the drug is used to treat meningitis , septicemia , peritonitis and other intra-abdominal infections, as well as in gynecological practice for endometritis and parametritis . The drug can be prescribed as a prophylactic during surgical interventions.
Side effect
From the nervous system and sensory organs: dizziness , headache , insomnia , paresthesia , cramps , diplopia , malaise, confusion, weakness, tinnitus, ulceration of the oral mucosa, taste perversion, numbness of the tongue , sneezing, nasal congestion , unpleasant smell from the mouth.
From the CCC and blood (hematopoiesis, hemostasis): lowering blood pressure , transient changes in the ECG (ventricular bigemia and premature ventricular contraction), flushing, pancytopenia, neutropenia, thrombocytopenia , anemia , eosinophilia , leukocytosis , thrombocytosis.
From the respiratory system: wheezing, shortness of breath , chest pain.
From the digestive tract : spastic abdominal pain, hepatitis , jaundice ; rare cases of diarrhea caused by C. difficile, including pseudomembranous colitis or gastrointestinal bleeding. The onset of symptoms of pseudomembranous colitis is possible both during and after treatment with the drug.
From the skin: toxic epidermal necrolysis, petechiae, purpura , erythema multiforme , exfoliative dermatitis , urticaria , pruritus , profuse sweating .
Allergic reactions: anaphylaxis , angioedema, bronchospasm .
Other: muscle pain, vaginal candidiasis , vaginitis , breast tenderness , fever , increased activity of AST , ALT , alkaline phosphatase , increased PV and APTT , Coombs positive test, hypercreatininemia; local reactions: with the on / in the introduction - phlebitis , thrombophlebitis , discomfort at the site of the / m introduction.