Aztreonam

With the active ingredient Aztreonam it is a monobactam antibiotic. The agent is used to treat infections with aerobic gram-negative bacteria.

What is Aztreonam?

Aztreonam is the name of an antibiotic that belongs to the group of monobactams. The drug has pharmacodynamic and pharmacokinetic properties similar to penicillin. Aztreonam only works against gram-negative bacteria.

The clinical relevance of the active ingredient is classified as low in medicine, so that it is mostly used as a reserve antibiotic. Monobactams have no influence on gram-positive bacteria.

Aztreonam received its approval in Europe in the mid-1980s. As a dry substance, the agent is administered parenterally (past the intestine). As a monopreparation, the antibiotic, which is the only representative of the monobactams, is represented in German-speaking countries under the trade names Azactam® and Cayston®.

Pharmacological effect

In its chemical structure, aztreonam belongs to the subgroup of beta-lactam antibiotics. The penicillins are also part of this group. Aztreonam has the ability to bind to the same proteins that penicillin can attach to.

The monobactam antibiotic is able to significantly disrupt the structure of the bacterial cell walls. This in turn results in the dissolution of the bacterial cell. Aztreonam binds to the penicillin-binding protein and blocks it with its lactam ring in such a way that mucopeptides can no longer form bonds with one another. This creates a growth stoppage, which aztreonam helps to kill bacteria.

Aztreonam is also effective against aerobic (oxygen-loving) gram-negative bacteria, which also include Pseudomonas aeruginosa. This germ is considered to be very dangerous and difficult to treat, so that it often causes life-threatening infections.

The bioavailability of aztreonam is 100 percent. In the blood, 56 percent of the antibiotic binds to plasma proteins. The drug is metabolized via the liver. The plasma half-life averages 1.7 hours. Aztreonam is then broken down from the body via the kidneys.

Medical application & use

Aztreonam is used primarily to treat cystic fibrosis. This cystic fibrosis is an inherited metabolic disease. An excess of thick mucus is formed in the respiratory tract of the affected person. The mucus cannot be coughed up naturally, so bacteria receive an ideal breeding ground. Therefore, the risk of contracting an infection is particularly high in cystic fibrosis patients.

Aztreonam is extremely effective in the treatment of chronic pneumonia, for which the bacterium Pseudomonas aeruginosa is responsible. The antibiotic can be given from the age of six.

In combination with metronidazole, Aztreonam is also used against infections within the abdomen. Together with clindamycin, the monobactam antibiotic is considered helpful against gynecological infections.

Aztreonam can be given by inhalations or intravenous or intramuscular injections. The absorption of the antibiotic into the organism takes place by bypassing the gastrointestinal tract.

Risks & side effects

Treatment with aztreonam can cause side effects in some patients. Symptoms such as sore throat, throat pain, stuffy nose, wheezing, coughing, breathing problems and fever are the main symptoms.

It is not uncommon for a bloody cough, a runny nose, bronchial cramps, chest pain, joint problems and rashes on the skin to occur. Pulmonary function tests show reduced values ​​for some of those affected. In some cases there is swelling of the joints.

If aztreonam is administered via the vein, there is a risk of undesirable side effects such as an allergic shock, severe skin reactions, punctiform skin bleeding, bleeding in the subcutaneous tissue, sweating, itching and nettle rash.

Aztreonam must not be used at all if the patient is hypersensitive to the monobactam antibiotic. A careful examination by the attending physician is necessary if there is an allergy to beta-lactam antibiotics such as cephalosporins, penicillins or carbapenems, if the patient is prone to a bloody cough or bronchial cramps when administering aerosols, or if there is poor lung function or kidney function disorders. The same applies to an already existing infestation with resistant germs such as Pseudomonas aeruginosa and Burkholderia cepacia.

To date, there is no information about the administration of aztreonam during pregnancy. Nevertheless, it is recommended that the antibiotic only be administered if the doctor deems it absolutely necessary. Because aztreonam is inhaled only in small quantities into the child's body while breastfeeding, it is permitted to be taken during breastfeeding. Aztreonam should not be given to children under six years of age, as there is no knowledge of its effects on small children.

There are no known interactions between aztreonam and other drugs. In addition, there is hardly any absorption of the active ingredient into the body during inhalation.