Pharmacokinetics of aztreonam in critically ill surgical patients

Edward E. Cornwell, Howard Belzberg, Thomas V. Berne, Mark A. Gill, Dimitrios Theodorou, Jack W. Kern, Winnie Yu, Juan A. Asensio, Demetrios Demetriades

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

The pharmacokinetics of aztreonam in critically ill surgical patients with serious gram-negative infections were studied. Blood samples were taken before and at 30 minutes, 2.5 hours, and 5 hours after a dose of aztreonam 2 g i.v. every six hours. All patients had received at least two aztreonam doses before the dosage interval being studied. Aztreonam concentrations were measured by high-performance liquid chromatography. Aztreonam's pharmacokinetics, the severity of illness, and patient outcomes were examined. A total of 28 patients with 111 serum aztreonam concentrations were included in the analysis. The patients were young (mean age, 35 years) and predominantly male. The mean APACHE II score was 19.3, and 22 patients had sepsis. Four patients died. The mean volume of distribution (V) of 0.35 L/kg was nearly twice the previously reported steady-state value for healthy volunteers (0.18 L/kg) and was highly variable. A slightly higher than normal mean V, 0.22 L/kg, was seen in a subset of six patients whose infection occurred earlier in their intensive care and who had lower APACHE II scores. While with some antibiotics the elevated V would imply difficulty in achieving therapeutic drug levels, 99 (89%) of the 111 concentrations were at or above the in vitro susceptibility breakpoint of 8 μg/mL. Despite observations of markedly increased and highly variable V in critically ill surgical patients, a standard dosage of aztreonam was usually sufficient to maintain adequate serum drug levels.

Original languageEnglish
Pages (from-to)537-540
Number of pages4
JournalAmerican Journal of Health-System Pharmacy
Volume54
Issue number5
StatePublished - 1997
Externally publishedYes

Fingerprint

Aztreonam
Critical Illness
Pharmacokinetics
APACHE
Critical Care
Infection
Serum
Pharmaceutical Preparations
Sepsis
Healthy Volunteers
High Pressure Liquid Chromatography
Anti-Bacterial Agents

All Science Journal Classification (ASJC) codes

  • Pharmaceutical Science
  • Leadership and Management

Cite this

Cornwell, E. E., Belzberg, H., Berne, T. V., Gill, M. A., Theodorou, D., Kern, J. W., ... Demetriades, D. (1997). Pharmacokinetics of aztreonam in critically ill surgical patients. American Journal of Health-System Pharmacy, 54(5), 537-540.

Pharmacokinetics of aztreonam in critically ill surgical patients. / Cornwell, Edward E.; Belzberg, Howard; Berne, Thomas V.; Gill, Mark A.; Theodorou, Dimitrios; Kern, Jack W.; Yu, Winnie; Asensio, Juan A.; Demetriades, Demetrios.

In: American Journal of Health-System Pharmacy, Vol. 54, No. 5, 1997, p. 537-540.

Research output: Contribution to journalArticle

Cornwell, EE, Belzberg, H, Berne, TV, Gill, MA, Theodorou, D, Kern, JW, Yu, W, Asensio, JA & Demetriades, D 1997, 'Pharmacokinetics of aztreonam in critically ill surgical patients', American Journal of Health-System Pharmacy, vol. 54, no. 5, pp. 537-540.
Cornwell EE, Belzberg H, Berne TV, Gill MA, Theodorou D, Kern JW et al. Pharmacokinetics of aztreonam in critically ill surgical patients. American Journal of Health-System Pharmacy. 1997;54(5):537-540.
Cornwell, Edward E. ; Belzberg, Howard ; Berne, Thomas V. ; Gill, Mark A. ; Theodorou, Dimitrios ; Kern, Jack W. ; Yu, Winnie ; Asensio, Juan A. ; Demetriades, Demetrios. / Pharmacokinetics of aztreonam in critically ill surgical patients. In: American Journal of Health-System Pharmacy. 1997 ; Vol. 54, No. 5. pp. 537-540.
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