Disease relevance of aztreonam

• Aztreonam for cystic fibrosis patients who are hypersensitive to other beta-lactams [1].
• Aztreonam in CAPD peritonitis [2].
• 11 further patients, with renal failure or gentamicin-resistant isolates, treated with aztreonam were all cured [3].
• Aztreonam failure in typhoid fever [4].
• Aztreonam-induced anaphylaxis [5].

High impact information on aztreonam

• Immediate hypersensitivity to aztreonam [6].
• We demonstrate that our error-prone Pol I can be used to generate enzymes with distinct properties by generating TEM-1 beta-lactamase mutants able to hydrolyze a third-generation lactam antibiotic, aztreonam [7].
• Because the use of aztreonam as the initial empirical treatment requires a concomitant antibiotic against gram-positive infections and the possibility of streptococcal superinfections, cefotaxime seems to be a more advantageous therapeutic alternative for this patient population [8].
• Streptococcal superinfections developed in three patients (14.2%) in the aztreonam group [8].
• In the remaining patients, signs and symptoms of infection were promptly controlled, and ascitic fluid cultures became negative after 48 hr in all cases, except in one patient from the aztreonam group, who was a clinical failure [8].

Chemical compound and disease context of aztreonam

• Overall, aztreonam was superior to tobramycin for treatment of pneumonia due to susceptible gram-negative bacteria in these critical care patients [9].
• Reinfection and superinfection were most commonly caused by enterococci in the aztreonam groups and by Pseudomonas aeruginosa in the cefamandole group [10].
• Two clinical isolates of Klebsiella pneumoniae from seriously ill patients in Chicago, Ill., have been identified as resistant to ceftazidime and aztreonam but susceptible to other cephalosporins [11].
• Imipenem and aztreonam are nontoxic to the albino rabbit retina at concentrations that are 500-fold higher than their effective dose against bacterial infection [12].
• Mutants of Enterobacter cloacae, selected in vitro with ceftriaxone, ceftazidime, carumonam, or aztreonam, fell into several distinct classes [13].

Biological context of aztreonam

• In contrast, the A237G substitution acts additively with the G238S:E240K substitutions to increase aztreonam hydrolysis [14].
• Review of the clinical pharmacology of the monobactam antibiotic aztreonam [15].
• Clinical pharmacokinetics of aztreonam. An update [16].
• Kinetics of intramuscular aztreonam followed a one-compartment model with first-order absorption and elimination [17].
• Kinetics analysis revealed that GIM-1 has no clear preference for any substrate and did not hydrolyze azlocillin, aztreonam, and the serine-beta-lactamase inhibitors. bla(GIM-1) was found on a 22-kb nontransferable plasmid [18].

Anatomical context of aztreonam

• Aztreonam in the treatment of urinary tract infection [10].
• Aztreonam is widely distributed in body fluids and tissues, and concentrations exceeding the minimal inhibitory concentrations of important gram-negative pathogens are attained in those compartments in which infections are most common [15].
• Aztreonam was used in the initial treatment of infection of the urinary tract (23 cases), respiratory tract (17 cases), skin and soft tissue (12 cases), abdominal cavity (three cases), endocarditis (two cases), septicemia (eight cases), and osteomyelitis (two cases) [19].
• The concentrations of aztreonam in cerebrospinal fluid ranged from 3.5 to 62 micrograms/ml, depending on the sampling time and the time elapsed since the onset of the disease [20].
• Penetration of aztreonam into cerebrospinal fluid of patients with and without inflamed meninges [21].

Associations of aztreonam with other chemical compounds

• Mutants selected for aztreonam hydrolysis exhibited a Gly for Ala substitution at position 237, a Ser for Gly substitution at position 238, and a Lys/Arg for Glu at position 240 [14].
• Treatment with aztreonam or tobramycin in critical care patients with nosocomial gram-negative pneumonia [9].
• The OHIO-1 beta-lactamase does not normally hydrolyse oxyimino-beta-lactam substrates like cefotaxime, ceftriaxone, ceftazidime or aztreonam [22].
• In pulse-chase experiments with a radioactive lipid precursor, ciprofloxacin, imipenem, and aztreonam inhibited phospholipid translocation into the OM [23].
• This unusual antibiogram was shown to be due to a novel plasmid-mediated beta-lactamase which readily hydrolyzed ceftazidime and aztreonam in addition to penicillins such as piperacillin and carbenicillin [11].

Gene context of aztreonam

• To evaluate the validity of our in vitro evolution method as a model for natural evolutionary processes, the TEM-1 beta-lactamase gene was evolved in vitro and was selected for increased resistance to cefotaxime, cefuroxime, ceftazadime, and aztreonam, i.e., the "extended-spectrum" phenotype [24].
• Both continuous metronidazole and aztreonam reduced lung MPO concentration (P < 0.05) and TNF-alpha and IL-1 beta mRNA expression (P < 0.05) compared with those in saline controls [25].
• Mutation of the ampC and/or ampH genes in E. coli lacking PBPs 1a and 5 produced morphologically aberrant cells, particularly in cell filaments induced by aztreonam [26].
• The clinical isolate Escherichia coli PEY was highly resistant to amoxycillin, ticarcillin and piperacillin associated to beta-lactamase inhibitors such as clavulanic acid, sulbactam, tazobactam and brobactam but susceptible to cephalosporins, aztreonam and imipenem [27].
• Deletion mutants in amiA, B and C were growing in long chains of unseparated cells and displayed a tolerant response to the normally lytic combination of aztreonam and bulgecin [28].

Analytical, diagnostic and therapeutic context of aztreonam

• MAIN OUTCOME MEASURE--We examined time of clinical recovery, treatment failures, adverse experiences, and microbiologic eradication from stool of the etiologic agent in subjects randomized to receive aztreonam or placebo [29].
• Aztreonam, for example, is active against most gram-negative pathogenic bacteria and has been evaluated in several clinical trials in neutropenic patients [30].
• None of 41 patients with documented IgE-reactive skin tests to various penicillin determinants concurrently demonstrated reproducible reactivity to any aztreonam reagents [31].
• Multicenter trials were conducted to determine the safety and efficacy of aztreonam in the treatment of patients with gram-negative bacterial infections [32].
• High-pressure liquid chromatographic (HPLC) systems were developed for the quantitative analysis of aztreonam in human, monkey, rat, mouse, and rabbit sera and urine [33].

References