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Single‐dose pharmacokinetics of aztreonam in children with cystic fibrosis
Author(s) -
Reed Michael D.,
Aronoff Stephen C.,
Stern Robert C.,
Yamashita Toyoko S.,
Myers Carolyn M.,
Friedhoff Lawrence T.,
Blumer Jeffrey L.
Publication year - 1986
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.1950020506
Subject(s) - aztreonam , pharmacokinetics , cystic fibrosis , medicine , volume of distribution , urine , dosing , pharmacology , metabolite , minimum inhibitory concentration , antibiotics , microbiology and biotechnology , biology , antibiotic resistance , imipenem
Abstract The single‐dose pharmacokinetics of aztreonam was evaluated in 10 clinically stable subjects with cystic fibrosis. Each child received 30 mg aztreonam/kg intravenously over 2 to 3 minutes. Multiple timed blood samples were obtained over 8 hours for determination of aztreonam elimination kinetics; all urine excreted for 24 hours was collected in timed aliquots for the determination of aztreonam and its microbiologically inactive metabolite, SQ 26,992. Aztreonam pharmacokinetic parameters were determined by model‐independent methods. Mean t1/2, steady‐state volume distribution, and body clearance were 1.3 hr, 0.25 L/kg, and 127.2 ml/min/1.73m 2 , respectively. In 9 of the 10 subjects, two‐compartment pharmacokinetic analysis was possible and compared favorably with model‐independent parameter estimates. Twenty‐four‐hour urinary recovery of aztreonam was 76.3% of the administered dose; 2.6% was recovered as the metabolite SQ 26,992. The renal clearance of aztreonam averaged 92.5 ml/min/1.73m 2 . When these data are combined with in vitro susceptibility data for aztreonam against Pseudomonas aerusinosa isolated from the sputum of patients with cystic fibrosis, a dose of 200 mg aztreonam/kg/day divided six hourly would be predicted to maintain serum concentrations above the minimum inhibitory concentration (MIC) for these organisms for the majority of the dosing interval.