Pharmacokinetics of aztreonam in infected patients

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Abstract
Pharmacokinetic parameters of aztreonam were determined in 22 patients with severe Gram-negative infections, treated with 0.5 or 1 g tid as an infusion of 30 min duration. Plasma concentrations were determined microbiologically. Most patients had various degrees of renal impairment and they showed a wide variety of age and body weight. The mean calculated volume of distribution was 17.31 or 260 ml/kg. The total plasma clearance correlated well with the creatinine clearance; the mean plasma clearance was 82 ml/min and the extrapolated extrarenal clearance was 9 ml/min. Actually measured half lives of aztreonam varied between 1 h 20 min, in a patient with normal renal function, and 9 h 40 min in a patient with severely impaired renal function. The results differ from predictions by other authors. Based on our results a dosage adjustment schedule for renal impairment is suggested.