氨曲南
Aztreonam
別名: Azactam · Cayston · Monobac · Aztreotic · Azenam · Primbactam · Trezam · Urobactam · Aztreonamum · Azthreonam · Atstreonaami · SQ-26776
由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
各物種劑量
🌎 NA — North America🌍 EU — Europe
狗
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Serious gram-negative infections | 30 mg/kg | IM or IV | q6-8h | — | 🌎 NA |
- Serious gram-negative infections: Anecdotal dosing suggestion based on the human pediatric dose. Aztreonam has a shorter half-life in dogs but is about half as bound to plasma proteins compared to humans.
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
概覽
氨曲南 (Aztreonam) 是一種單環β-內醯胺類注射用抗生素，主要用於對抗多種需氧及兼性厭氧革蘭氏陰性菌。
- 抗菌譜： 對檸檬酸桿菌、腸桿菌、大腸桿菌、克雷伯氏菌、變形桿菌、假單胞菌和沙雷氏菌具有高度療效。
- 臨床要點： 對革蘭氏陽性菌或厭氧菌沒有臨床療效。
- 臨床應用： 當氨基醣苷類或氟喹諾酮類藥物無效或有相對禁忌症（例如腎毒性疑慮）時，常被考慮用於嚴重的革蘭氏陰性菌感染。
- 具有良好的組織穿透力且毒性潛力低，儘管在獸醫目標物種中的臨床經驗和藥代動力學數據仍然有限。
作用機制
Aztreonam is a bactericidal antibiotic.
- It selectively binds to penicillin-binding protein-3 (PBP-3) in susceptible bacteria.
- Binding to PBP-3 → inhibits bacterial cell wall synthesis → results in cell lysis and death.
- It is highly stable against the hydrolytic effects of bacterial beta-lactamases and, unlike many other beta-lactam antibiotics, does not induce beta-lactamase activity.
- Synergy: Can exhibit synergistic effects against Pseudomonas aeruginosa and other gram-negative bacilli when used concurrently with aminoglycosides.
安全性與警告
禁忌症
- Documented severe hypersensitivity to aztreonam
不良反應
- Hypersensitivity reactions
- Gastrointestinal effects (bacterial overgrowth, pseudomembranous colitis, diarrhea)
- Pain and/or swelling after IM injection
- Phlebitis after IV administration
- Transient increases in liver enzymes, serum creatinine, and coagulation indices
注意事項
Use cautiously in patients with serious renal or liver dysfunction; dosage adjustment may be needed. Aztreonam may cause false-positive urine glucose determinations when using cupric sulfate solutions (e.g., Benedict's Solution, Clinitest). Tests utilizing glucose oxidase are not affected.
藥物相互作用
Can reduce the renal tubular secretion of aztreonam, thereby maintaining higher systemic levels for a longer period of time. This potential 'beneficial' interaction requires further investigation in veterinary patients.
監測
- Clinical efficacy
- Signs of toxicity or adverse effects
- Renal and hepatic function in compromised patients
藥物動力學
半衰期
吸收
In dogs, after a 20 mg/kg IM dose, peak plasma levels of approximately 40 mcg/mL occur in about 20 minutes.
分佈
Serum protein binding in dogs is about 20-30% (compared to 65% in humans). High tissue levels are found in the kidney (~2.5x plasma levels). Liver concentrations approximate plasma levels; lower levels are found in the lung and spleen. Crosses the placenta and is detected in fetal circulation. Excreted in breast milk at ~1% of serum levels.
代謝
Minimal hepatic metabolism.
排除
Primarily (80%) excreted unchanged in the urine in dogs.
過量
There is little reason for concern in patients with adequate renal function. The IV LD50 for mice is 3.3 g/kg. Hemodialysis or peritoneal dialysis may be used to clear aztreonam from the circulation.
可用產品
劑型
- Injection (lyophilized cake or powder for solution)
- Powder for inhalation solution
人用標示
- Aztreonam Injection (lyophilized cake or powder for solution): 500 mg, 1 g, 2 g single-dose vials and infusion bottles
- Aztreonam Powder (lyophilized) for inhalation solution: 75 mg
各地核准狀態
暫無法規資料: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
Store commercially available powder for reconstitution at room temperature (15°-30°C). Reconstituted IM solutions are stable for 48 hours at room temperature, or 7 days if refrigerated. Intravenous solutions not exceeding 20 mg/mL are stable for 48 hours at room temperature, or 7 days if refrigerated. Solutions may be colorless or light straw yellow; upon standing, a light pink color may develop which does not affect the drug's potency.
飼主須知
重要提示： 此藥物僅應由獸醫專業人員給藥。
- 由於需要頻繁的給藥間隔（每6-8小時一次），此藥物最適合在醫院環境中對住院病患使用。
- 如果您的寵物正在哺乳，該藥物通常被認為是安全的，但請密切觀察哺乳幼崽是否有抗生素相關性腹瀉的跡象。
VetSheet 藥物參考供持牌獸醫專業人員作臨床決策輔助之用，不能取代專業判斷或廠方最新藥品說明書。