Chris A.

Yohannes
 We recommended that intravenous
antibiotic therapy started as early as
possible and within the first hour of
recognition of septic shock (grade 1b) and
severe sepsis without septic shock (grade
1d). Appropriate culture should be obtained
before initiating antibiotic therapy but
should not prevent prompt administration of
antimicrobial therapy (grade 1d)
We recommended that initial anti infective
therapy include one or more drugs that have
activity against all likely pathogen and that
penetrate in adequate concentration into
the presume source of infection (grade 1 b)
We recommended that the antimicrobial
regimen be reassessed daily to optimize
activity, to prevent development of
resistance, to reduce toxicity and to reduce
cost (grade 1 c)
We suggest combination therapy for patient
with known or suspected Pseudomonas
infection as a cause of severe sepsis (grade 2
d)
We suggest combination empirical therapy
for neutropenic patient with severe sepsis
(grade 2 d)
When used empirical in patient with severe
sepsis, we suggest that combination therapy
should not be administered for > 3-5 days.
Deescalation to the most appropriate single
therapy should be performed as soon as the
susceptibility profile is known (grade 2d)
We recommended that the duration of
therapy typically be 7-10 days; longer
courses may be appropriate in patient who
have a slow clinical response, undrainable
foci of infection or immunologic deficiencies
including neutropenia (grade 1 d)
ANTIBACTERIAL ACTIVITY AZTREONAM

No activity against gram Stable to hydrolysis by a wide

(+) and anaerobic bacteria range of -lactamase
Completely absorbed after IM
Active against gram (-) injection
bacteria V distribution 0,15-0,18 L/kg
Enterobacteriaceae (total drug) and 0,4 L/kg (free
H. influenzae drug)
N. gonorrhoea
Present in prostatic tissue,
cerebrospinal fluid, and skin
Salmonella
blister fluid
Shigella Excretion is mainly via the
P. aeruginosa urine
Well tolerated by most
patients
THERAPEUTIC DOSAGE

Urinary tract infection Adult

Lower respiratory tract 1-2 g every 8-12 hour
infection 2 g every 6-8 hour (serious
Intra abdominal infection pseudomonas infection)
Obstetric and Paediatric
gynaecological infection 30 mg/kg every 6-8 hour
Septicaemia
Bone and joint infection
Skin and soft tissue
infection
Am J Surg 2000; 179 (Suppl 2 A) : 45s-50 S
Thank You
Thank You

Thank You
Thank You