Adult Dosing

Respiratory symptoms in cystic fibrosis (CF) with Pseudomonas aeruginosa

• 75 mg NEB inhaled tid x 28 days

• Use one single-use vial reconstituted with 1 mL of sterile diluent before administration
• Use dose immediately after reconstitution
• Do not administer with any other type of nebulizer

Pediatric Dosing

Respiratory symptoms in cystic fibrosis (CF) with Pseudomonas aeruginosa

Children >7 yrs

• 75 mg NEB inhaled tid x 28 days

• Use one single-use vial reconstituted with 1 mL of sterile diluent before administration
• Use dose immediately after reconstitution
• Do not administer with any other type of nebulizer

[Outline]

• Adult Dosing
• Pediatric Dosing

• To improve respiratory symptoms in cystic fibrosis (CF) patients with Pseudomonas aeruginosa

• Hypersensitivity to any of the ingredients of the product

• N/A

Renal Dose Adjustment

• Renal impairment: No dose adjustment

Hepatic Dose Adjustment

• Hepatic impairment: Dose adjustments not defined

• Inhalational aztreonam may cause allergic reactions. Allergic reactions such as facial rash, facial swelling, and throat tightness have been reported following administration of aztreonam injection to patients with no known history of exposure to aztreonam. Discontinue therapy if an allergic reaction occurs and initiate treatment as appropriate
• Cross-reactivity may occur in patients with a history of allergy to beta-lactam antibiotics, such as penicillins, cephalosporins, and/or carbapenems. Use cautiously in patients with a history of beta-lactam allergy
• Bronchospasm has been associated with nebulised therapies. Patients should advised to use a bronchodilator before each dose. If a case of bronchospasm is suspected to be part of an allergic reaction appropriate measures should be taken
• Safety and efficacy have not been established in patients with FEV1 <25% or >75% predicted, or patients colonized with Burkholderia cepacia, consider patient’s baseline FEV1 prior to therapy and the presence of other symptoms when evaluating whether post-treatment changes in FEV1 are caused by a pulmonary exacerbation
• Therapy in the absence of known Pseudomonas aeruginosa infection in patients with CF may increase the risk of development of drug-resistant bacteria

Pregnancy Category:B

Breastfeeding: Probably Safe; Limited information indicates that single maternal doses of aztreonam of 1 gram produce low levels in milk that are not expected to cause adverse effects in breastfed infants. Occasionally, disruption of the infant's gastrointestinal flora, resulting in diarrhea or thrush, has been reported with beta-lactams, but these effects have not been adequately evaluated. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/ht mlgen?LACT last accessed 21 December 2012). Maternal medication usually compatible with breastfeeding, no observable change was seen in the nursing infant while the mother was ingesting the compound. This information is based upon data from AAP Policy Guidelines (available at http://aappolicy.aappublications.org/cgi/content/full/pediatrics;108/3/776 last accessed 21 December 2012).

• GI: Abdominal pain, vomiting
• RESP: Cough, nasal congestion, wheezing, pharyngolaryngeal pain, chest discomfort, bronchospasm
• DERM: Rash
• HYPERSENSITIVITY: Hypersensitivity reactions
• MISC: Pyrexia

• Monobactam antibacterial; it inhibits cell wall synthesis by binding to penicillin binding proteins of susceptible bacteria, which leads to death of the cell
• Minimally metabolized by liver
• Excreted in urine (10% unchanged) and feces
• Half-life: Approximately 2.1 hrs

US Trade Name(s)

• Cayston

US Availability

Cayston

• PWDR: 75 mg/vial

Canadian Trade Name(s)

• Cayston

Canadian Availability

Cayston

• PWDR: 75 mg/vial

UK Trade Name(s)

• Cayston

UK Availability

Cayston

• PWDR: 75 mg/vial

Australian Trade Name(s)

• N/A

Australian Availability

• N/A

[Outline]

Pulmonary

Antibiotics

monobactams

Antimicrobials

Antibiotics

monobactams