Aztreonam adverse effects

Aztreonam may be used as a substitute for an aminoglycoside in the treatment of infections caused by susceptible gram-negative organisms. Most of the adverse effects of aztreonam are local reactions at the site of injection. Interestingly, aztreonam rarely causes allergic reactions in patients with a history of type I hypersensitivity to other (3-lactam antibiotics. 

Adverse effects Aztreonam is relatively nontoxic, but it may cause phlebitis, skin rash, and occasionally, abnormal liver function tests. Aztreonam has a low immunogenic potential and shows little cross-reactivity with antibodies induced by other p-lac-tams. Thus aztreonam may offer a safe alternative for treating patients allergic to penicillins and/or cephalosporins. 

Aztreonam is administered intravenously and is eliminated via renal tubular secretion. Its half-life is prolonged in renal failure. Adverse effects include gastrointestinal upset with possible superinfection, vertigo and headache, and rare hepatotoxicity. Though skin rash may occur, there is no cross-allergenicity with penicillins. 

The monobactams have a single beta-lactam ring structure. The only clinically used monobactam is aztreonam. Replacement of the 1-sulfonic acids residue in monobactam with an Af-sulphonylated carbonyl amino moiety yields monocarbams [71, 72 ]. So far, however, no monocarbam derivative is on the market, probably because their antimicrobial moiety is not optimal. Since micro-organisms need iron for growth, some siderophore-conjugated monocarbams are now under evaluation [73 ]. It is reasonable to assume that it will take some time until they are marketed. One of the many problems not yet solved is the in vivo fate of the siderophore itself, since it may create some new adverse effects of its own. 

Drug formulations In February 2010, a solution of aztreonam for inhalation, formulated with lysine, was approved by the US FDA for the treatment of respiratory symptoms in patients with cystic fibrosis and infected with Pseudomonas aeruginosa [75 ], a bacterium that has always been difficult to treat with antibiotics, especially when it grows in biofilm, as is the case in the airways. So far, no new types of adverse effects have been found [76 ]. A key problem will be the development of resistance to this new formulation [77 ]. 

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