Adult Dosing
Urinary tract infections
- 500 mg or 1 g IM/IV q8-12 hrs
- Max: 8 g/day
Moderate-severe systemic infections
- 1-2 g IV/IM q8-12 hrs
- Max: 8 g/day
Severe systemic or life-threatening infections
- 2 g IM/IV q6 hrs
- Max: 8 g/day
Pediatric Dosing
Mild to moderate infections
Child 9 mo-16 yrs
- 30 mg/kg IV q8 hrs
- Max: 120 mg/kg/day
Moderately severe systemic infections
Child 9 mo-16 yrs
- 30 mg/kg IV q6-8 hrs
- Max: 120 mg/kg/day
Renal Dose Adjustment (Based on CrCl)
Adults
- 10-30 mL/min: Reduce dose by 1/2 after an initial dose of 1 to 2 g
- <10 mL/min
- Initial dose of 500 mg to 2 g should be followed by 1/4 of the usual dose at usual intervals of 6, 8 or 12 hrs
- Serious or life-threatening infections: 1/8 of the initial dose given after each session of hemodialysis
Child 9 mo-16 yrs
- >50 mL/min: Reduce dose by 25%
- 10-50 mL/min: Reduce dose by 50%
- <10 mL/min: Reduce dose by 75%
Hepatic Dose Adjustment
- Hepatic impairment: Dose adjustments not defined, caution advised
- Hypersensitivity reactions in patients with or without prior exposure may occur as aztreonam is rarely cross-reactive with other beta-lactam antibiotics and weakly immunogenic
- Discontinue the drug and institute appropriate supportive treatment if an allergic reaction to aztreonam occurs
- Therapy may cause Clostridium difficile associated diarrhea (CDAD) and may range in severity from mild diarrhea to fatal colitis. Patients who present with diarrhea following antibiotic use must be considered for CDAD. Careful medical history is necessary
- Toxic epidermal necrolysis have been reported in association with aztreonam in patients undergoing bone marrow transplant
- Use in the absence of a proven or strongly suspected bacterial infection or a prophylactic indication increases the risk of the development of drug-resistant bacteria
- Appropriate monitoring is recommended in patients with impaired hepatic or renal function
- Monitor renal functions if an aminoglycoside is used concurrently with aztreonam because of the potential nephrotoxicity and ototoxicity of aminoglycoside antibiotics
- Superinfection may occur during therapy, appropriate measures should be taken
Cautions: Use cautiously in
- Renal impairment
- Hepatic impairment
- Hx of diarrhea
- Hypersensitivity to beta-lactams
Pregnancy Category:B
Breastfeeding: Probably Safe. 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/T6 last accessed 18 February 2011). Manufacturer advises temporary discontinuation of nursing.
US Trade Name(s)
US Availability
aztreonam (generic)
- PWDR for INJ: 500 mg/vial
- PWDR for INJ: 1 g/vial
- PWDR for INJ: 2 g/vial
Azactam
- PWDR for INJ: 500 mg/vial (discontinued)
- PWDR for INJ: 1 g/vial
- PWDR for INJ: 2 g/vial
- SOLN for INJ: 1 g/50 mL
- SOLN for INJ: 2 g/50 mL
Azactam in plastic container
- INJ: 40 mg/mL
- INJ: 20 mg/mL
Canadian Trade Name(s)
Canadian Availability
UK Trade Name(s)
UK Availability
Azactam
- PWDR for INJ: 1 g/vial
- PWDR for INJ: 2 g/vial
Australian Trade Name(s)
Australian Availability
Azactam