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Medicine 1998; 7(88): 4128-4134 Fig. 1. Estructura básica comparada de los anbitióticos con núcleo b-lactámico.
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biótico (PAE), medido sobre E.coli, Kleb- CMI: concentración mínima inhibitoria.
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ha sido eficaz y bien tolerado en el trata- Efectos adversos Klebsiella oxytoca resistance to aztreonam by overpro-
dution of the chromosomally encoded beta-lactamase.
miento de estos enfermos, tanto en adul-
FEMS Microbiol Lett 1994; 116: 31-36.
tos como en niños75-79. Entre las infeccio- Ni en animales de experimentación ni en 10. Barry AL, Thornsberry C, Jones RN, Garvar TL. Az-
nes graves hay buena experiencia en el el hombre, el aztreonam ha producido al- treonam antibacterial activity, b-lactamase stability and
tratamiento de meningitis causadas por teraciones indeseables importantes89. En el interpretative standards and Quality Control Guidelines
gramnegativos, como H.influenzae, ente- hombre, se han descrito en menos del 2% for disk susceptibility tests. Rev Infec Dis 1985; 7: 594-
604.
robacterias, N.meningitidis y Pseudomo- de los enfermos tratados, molestias loca- 11 Campos P, Vera A, Martín-Luengo F. In vitro acti-
nas, con dosis altas, 1-2 g en adultos, les en el lugar de la inyección, eosinofilia, vity of aztreonam and RO 17,2301 against multi-resis-
30-50 mg/kg de peso en niños, cada eritema cutáneo y elevaciones transitorias tant Pseudomonas aeruginosa strains. Eur J Clin Micro-
6-8 horas, con resultados favorables al de las enzimas hepáticas80,90,91. Al actuar biol 198..; 1: 71-72.
12. Landínez RJ, García Castro MA, Coladas N, Bratos
95%79. sólo sobre bacterias aerobias gramnegati-
MA, Alvarez E, Kastanos N. Actividad in vitro de
También se han tratado artritis sépticas vas, el aztreonam no modifica de manera aztreonam (SQ 26.776) sobre bacterias gramnegativas.
y osteomielitis causadas por P.aerugino- sustancial la flora intestinal, respetando las Med Clin 1984; 82: 106-109.
sa, con dosis de 2 gr cada 8 horas, du- bacterias anaerobias, fundamentalmente B. 13. Perl TM, Pfaller MA, Houston A, Wenzel RP. Effect
of serum on the in vitro activities of 11 broad-spectrum
rante 30 y 40 días, respectivamente, con fragilis, y por tanto el equilibrio de este
antibiotics. Antimicrob Agents Chemother. 1990; 34:
buenos resultados80. En los enfermos que- sistema ecológico, y sin disminuir la res- 2.234-2.239.
mados, con infección por P.aeruginosa puesta del huésped a la colonización por 14. Phillips I, King A, Shannon K, Warren C. SQ
multirresistente, aztreonam, al igual que bacterias resistentes, como ocurre con la 26,776. In vitro antibacterial activity and susceptibility
to b-lactamases. J Antimicrob Chemother 1981; 8
piperacilina, ha demostrado ser una bue- mayoría de las familias de antibióticos, no
(Suppl E): 103-110.
na elección cuando se compara con ami- afectando tampoco a la coagulación92. 15. Shah PM, Losert-Brügguer B, Stille W. Bacterial ac-
noglucósidos81. El aztreonam no se conjuga con los anti- tivity of SQ 26,776. J Antimicrob Chemother 1981; 8
El aztreonam se ha utilizado en niños, con cuerpos antipenicilinoicos de pacientes alér- Suppl E: 77-80.
dosis habituales de 30-50 mg/kg de gicos a la penicilina; por lo tanto no pare- 16. Hanberger H, Nilsson LE, Maller R, Nilsson M.
Pharmacodynamics of beta-lactam antibiotics on gram-
peso/día y mayores en otras ocasiones, en ce que existan inmunogenicidad cruzada negative bacteria: initial killing, morphology and pos-
el mismo tipo de infecciones que en los adul- con ella, pudiéndose administrar en pa- tantibiotic effect. Scand J InfectDis. 1990; 74: 118-23.
tos, también con buenos resultados82-84. cientes alérgicos a la misma. En general se 17. Hanberger H, Nilsson LE, Kihlstrom E, Maller R.
Atención especial merecen dos aplicacio- acepta la falta de alergia cruzada entre az- Postantibiotic effect of beta-lactam antibiotics on Esche-
richia coli evaluated by bioluminescence assay of bac-
nes: meningitis y fibrosis quística. La ade- treonam y otros b-lactámicos93,94 aunque
terial ATP. Antimicrob Agents Chemother 1990; 34:
cuada farmacocinética de aztreonam para se ha descrito algún caso aislado de reac- 102-106.
las infecciones meníngeas y la frecuencia ciones cutáneas a la prueba con aztreonam 18. Velluti G, Garuti GC, Binucchi ME, Gilioli F, Capelli O,
de las bacterias gramnegativas hacen que y uno de urticaria generalizada95. Rovatti E, Covi M. Activity of aztreonam in neumology:
Influence of phagocytosis and intracellular killing of hu-
el antibiótico esté indicado en estas si-
man alveolar macrophages. J Chemother 1994; 6: 44-49.
tuaciones. Al igual que ceftriaxona y ce- 19. Aronoff SC, Klinger JD. In vitro activities of aztreo-
fixima, aztreonam se ha usado con efica- nam, piperacillin and ticarcillin combined with amikacin
cia en el tratamiento de infecciones against amikacin-resistant Pseudomonas aeruginosa
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