氨曲南
**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.
各物種劑量
- Serious gram-negative infections · 30 mg/kg · IM or IV · q6-8h · 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。
給藥途徑
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
藥物相互作用
- Probenecid · 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
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.
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。