aztreonam/avibactam

Contraindicated in:

Hypersensitivity.

Use Cautiously in:

Renal impairment (CCr <50 mL/min);
Hepatic impairment;
OB: Safety not established in pregnancy;
Lactation: Safety not established in breastfeeding;
Pedi: Safety and effectiveness not established in children;
Geri: Consider age-related impairment of renal function in older adults.

Adv. Reactions/Side Effects ⬆ ⬇

Derm: flushing, rash, TOXIC EPIDERMAL NECROLYSIS (TEN)

GI: ↑liver enzymes, abdominal pain, CLOSTRIDIOIDES DIFFICILE-ASSOCIATED DIARRHEA (CDAD), constipation, diarrhea, nausea, vomiting

Hemat: anemia, eosinophilia, leukocytosis, thrombocytopenia, thrombocytosis

Local: phlebitis

Neuro: ageusia, dizziness, headache, insomnia, mental status changes

Misc: fever, hypersensitivity reactions

Interactions ⬆ ⬇

Drug-drug:

Concurrent use with probenecid not recommended.

Availability ⬆ ⬇

Powder for injection: aztreonam 1.5 g/avibactam 0.5 g/vial

Route/Dosage ⬆ ⬇

IV (Adults ): 2.67 g (2 g aztreonam/0.67 g avibactam) initially as loading dose, then 2 g (1.5 g aztreonam/0.5 g avibactam) every 6 hr for 5–14 days.

Renal Impairment

IV (Adults ): CCr 30–<50 mL/min: 2.67 g (2 g aztreonam/0.67 g avibactam) initially as loading dose, then 1 g (0.75 g aztreonam/0.25 g avibactam) every 6 hr for 5–14 days. CCr 15–<30 mL/min: 1.8 g (1.35 g aztreonam/0.45 g avibactam) initially as loading dose, then 0.9 g (0.675 g aztreonam/0.225 g avibactam) every 8 hr for 5–14 days. CCr <15 mL/min or Hemodialysis: 1.33 g (1 g aztreonam/0.33 g avibactam) initially as loading dose, then 0.9 g (0.675 g aztreonam/0.225 g avibactam) every 12 hr for 5–14 days.

US Brand Names ⬆ ⬇

Action ⬆ ⬇

Aztreonam: Binds to the bacterial cell wall membrane, causing cell death. Avibactam: Inhibits beta-lactamase, an enzyme that destroys penicillins and cephalosporins.

Therapeutic effects:

Death of susceptible bacteria with resolution of infection.

Spectrum:

Active against Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, Klebsiella oxytoca, Citrobacter freundii, and Serratia marcescens.

Classifications ⬆ ⬇

Therapeutic Classification: anti-infectives

Pharmacologic Classification: monobactams, beta lactamase inhibitors

Pharmacokinetics ⬆ ⬇

Aztreonam

Absorption: IV administration results in complete bioavailability.

Distribution: Widely distributed to tissues.

Metabolism/Excretion: 60–70% excreted unchanged by the kidneys. Small amounts metabolized by the liver.

Half-Life: 2 hr.

Avibactam

Absorption: IV administration results in complete bioavailability.

Distribution: Widely distributed to tissues.

Metabolism/Excretion: Minimally metabolized; mainly excreted unchanged in urine.

Half-Life: 2 hr.

Time/Action Profile ⬆ ⬇

(plasma concentrations)

ROUTE	ONSET	PEAK	DURATION
IV	rapid	end of infusion	unknown

Patient/Family Teaching ⬆ ⬇

Explain purpose and side effects of medication to patient. Advise patient to read Patient Information before starting therapy. Emphasize on the importance of completing the full course of therapy.
Advise patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to consult health care professional before taking other medications.
Advise patient about the hypersensitivity reactions that can occur and to notify health care professional or seek immediate medical attention.
Advise patient to notify health care professional if signs/symptoms of a severe rash, blistering or peeling skin with or without a fever or joint pain occur.
Advise patient to notify health care professional if severe watery or bloody diarrhea develops.
Rep: Advise women of reproductive potential to notify health care professional if pregnancy is planned or suspected or if breastfeeding.

Pronunciation ⬆ ⬇

AZ-tree-oh-nam/a-vi-BAK-tam

Code ⬆

NDC Code

0074- AbbVie Inc.
- 0074-3878- EMBLAVEO
  - 0074-3878-10- 10 VIAL, SINGLE-DOSE in 1 CARTON (0074-3878-10) / 12 mL in 1 VIAL, SINGLE-DOSE (0074-3878-01)

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Indications ⬇

Contraind./Precautions ⬆ ⬇