Skip to main content
Antimicrobial Agents and Chemotherapy logoLink to Antimicrobial Agents and Chemotherapy
. 1983 Aug;24(2):252–261. doi: 10.1128/aac.24.2.252

Pharmacokinetics of aztreonam in patients with various degrees of renal dysfunction.

J C Mihindu, W M Scheld, N D Bolton, D A Spyker, E A Swabb, W K Bolton
PMCID: PMC185147  PMID: 6685452

Abstract

We have studied the pharmacokinetics of 1-g intravenous doses of aztreonam in four groups of six volunteers each, distinguished by their creatinine clearances (greater than 80, 30 to 80, 10 to 29, and less than 10 ml/min). Subjects received 1 g of aztreonam intravenously without any complications. Aztreonam serum and urine levels were measured by microbiological methods and by high-pressure liquid chromatography, and unbound serum aztreonam was determined by ultrafiltration. Serum levels were well described by a two-compartment infusion model. From this model we determined steady-state volume of distribution, alpha distribution phase half-life, beta elimination phase half-life, and total clearance of aztreonam. The mean of beta elimination phase half-life ranged from 2 h in normal subjects to 6 h in anephric patients. The total clearance of aztreonam correlated closely with corrected creatinine clearance calculated from serum creatinine, age, and sex (r = 0.97, P less than 0.001) and ranged from a mean value of 107 ml/min in normal subjects to 29 ml/min in functionally anephric patients. Some 75% of aztreonam excretion was renal. Urinary recovery of aztreonam ranged from 58% of the administered dose in normal subjects to 1.4% in uremic patients. Free aztreonam in serum correlated inversely with creatinine clearance (P less than 0.001). A nomogram was developed as a guide for adjustment of aztreonam dosage according to renal function.

Full text

PDF
252

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Neu H. C., Labthavikul P. Antibacterial activity of a monocyclic beta-lactam SQ 26,776. J Antimicrob Chemother. 1981 Dec;8 (Suppl E):111–122. doi: 10.1093/jac/8.suppl_e.111. [DOI] [PubMed] [Google Scholar]
  2. Spyker D. A., Rugloski R. J., Vann R. L., O'Brien W. M. Pharmacokinetics of amoxicillin: dose dependence after intravenous, oral, and intramuscular administration. Antimicrob Agents Chemother. 1977 Jan;11(1):132–141. doi: 10.1128/aac.11.1.132. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Swabb E. A., Leitz M. A., Pilkiewicz F. G., Sugerman A. A. Pharmacokinetics of the monobactam SQ 26,776 after single intravenous doses in healthy subjects. J Antimicrob Chemother. 1981 Dec;8 (Suppl E):131–140. doi: 10.1093/jac/8.suppl_e.131. [DOI] [PubMed] [Google Scholar]
  4. Swabb E. A., Sugerman A. A., Frantz M., Platt T. B., Stern M. Renal handling of the monobactam azthreonam in healthy subjects. Clin Pharmacol Ther. 1983 May;33(5):609–614. doi: 10.1038/clpt.1983.82. [DOI] [PubMed] [Google Scholar]
  5. Swabb E. A., Sugerman A. A., Platt T. B., Pilkiewicz F. G., Frantz M. Single-dose pharmacokinetics of the monobactam azthreonam (SQ 26,776) in healthy subjects. Antimicrob Agents Chemother. 1982 Jun;21(6):944–949. doi: 10.1128/aac.21.6.944. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Sykes R. B., Bonner D. P., Bush K., Georgopapadakou N. H. Azthreonam (SQ 26,776), a synthetic monobactam specifically active against aerobic gram-negative bacteria. Antimicrob Agents Chemother. 1982 Jan;21(1):85–92. doi: 10.1128/aac.21.1.85. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Sykes R. B., Bonner D. P., Bush K., Georgopapadakou N. H., Wells J. S. Monobactams--monocyclic beta-lactam antibiotics produced by bacteria. J Antimicrob Chemother. 1981 Dec;8 (Suppl E):1–16. doi: 10.1093/jac/8.suppl_e.1. [DOI] [PubMed] [Google Scholar]
  8. Sykes R. B., Cimarusti C. M., Bonner D. P., Bush K., Floyd D. M., Georgopapadakou N. H., Koster W. M., Liu W. C., Parker W. L., Principe P. A. Monocyclic beta-lactam antibiotics produced by bacteria. Nature. 1981 Jun 11;291(5815):489–491. doi: 10.1038/291489a0. [DOI] [PubMed] [Google Scholar]
  9. Wise R., Andrews J. M., Hancox J. SQ 26,776, a novel beta-lactam: an in-vitro comparison with other antimicrobial agents. J Antimicrob Chemother. 1981 Dec;8 (Suppl E):39–47. doi: 10.1093/jac/8.suppl_e.39. [DOI] [PubMed] [Google Scholar]

Articles from Antimicrobial Agents and Chemotherapy are provided here courtesy of American Society for Microbiology (ASM)

RESOURCES