Aztreonam(az’ tree oh nam)
Azactam, Cayston
PREGNANCY CATEGORY B
Drug class
Monobactam antibiotic
Therapeutic Actions
Bactericidal: Interferes with bacterial cell wall synthesis, causing cell death in susceptible gram-negative bacteria, ineffective against gram-positive and anaerobic bacteria.
Indications
Treatment of UTIs, lower respiratory infections, skin and skin-structure infections, septicemia, intra-abdominal infections and gynecologic infections caused by susceptible strains of Escherichia coli, Enterobacter, Serratia, Proteus, Salmonella, Providencia, Pseudomonas, Citrobacter, Haemophilus, Neisseria, Klebsiella
Adjunct to surgery in managing infections caused by susceptible organisms (especially gram-negative aerobic pathogens)
Improvement of respiratory symptoms in cystic fibrosis patients with Pseudomonas aeruginosa infections (inhalation)
Unlabeled use: 1 g IM for treatment of acute uncomplicated gonorrhea as alternative to spectinomycin in penicillin-resistant gonococci
Contraindications and Cautions
Contraindicated with allergy to aztreonam.
Use cautiously with immediate hypersensitivity reaction to penicillins or cephalosporins, renal and hepatic disorders, lactation.
Available Forms
Powder for injection—500 mg, 1 g, 2 g; single-use vial for inhalation—75 mg
Dosages
Available for IV and IM use and inhalation; maximum recommended dose, 8 g/day.
Adults
UTIs: 500 mg–1 g IM or IV every 8–12 hr.
Moderately severe systemic infection: 1–2 g IM or IV every 8–12 hr.
Severe systemic infection: 2 g IM or IV every 6–8 hr.
Pediatric patients 9 mo and older
Mild to moderate infections: 30 mg/kg IM or IV every 8 hr.
Moderate to severe infections: 30 mg/kg IM or IV every 6–8 hr.
Maximum recommended dose, 120 mg/kg/day.
Adults and children 7 yr and older
Cystic fibrosis patients with P. aeruginosa infections: 75 mg inhalation using Altera Nebulizer System tid for 28 days; space doses at least 4 hr apart. Follow with 28 days off aztreonam.
Patients with renal impairment
Reduce dosage by one-half in patients who have estimated CrCl between 10 and 30 mL/min/1.73 m2 after an initial loading dose of 1 or 2 g. For CrCl less than 10 mL/min; reduce dosage by 25%. For patients on hemodialysis, give 500 mg, 1 g, or 2 g initially; maintenance dose should be one-fourth the usual initial dose at fixed intervals of 6, 8, or 12 hr. In serious or life-threatening infections, give an additional one-eighth of the initial dose after each hemodialysis session.
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