Aztreonam

3
Aztreonam
Brands

DEA Class; Rx

Common Brand Names; Azactam, Cayston

  • Monobactams

Synthetic beta-lactam antibiotic; spectrum limited to aerobic gram-negative bacteria; no gram-positive or anaerobic activity; less nephrotoxic than aminoglycosides; not indicated for meningitis. Aztreonam for inhalation indicated for CF patients >= 7 years.

Indicated for Systemic Infections, Pseudomonal Infections, Urinary Tract Infections, Cystic fibrosis.

Indicated to improve respiratory symptoms in patients with CF infected with Pseudomonas aeruginosa

Hypersensitivity

Inhalation

  • Cough (54%)

  • Sore throat (12%)

  • Wheezing (16%)

  • Fever (13%)

Injection

  • Pain at injection site (12%; children); (2%; adults)

  • Increase in serum transaminases (4-6%)

  • Neutropenia (3-11%, children); (<1%, adults)

In patients with impaired hepatic or renal function, appropriate monitoring is recommended during therapy

If aminoglycoside is used concurrently, especially if high dosages of former are used or if therapy is prolonged, renal function should be monitored because of potential nephrotoxicity and ototoxicity of aminoglycoside antibiotics

Use of antibiotics may promote overgrowth of nonsusceptible organisms, including Gram-positive organisms (Staphylococcus aureus and Streptococcus faecalis) and fungi; take appropriate measures if superinfection occur during therapy

Rare cases of toxic epidermal necrolysis reported in association with therapy in patients undergoing bone marrow transplant with multiple risk factors including sepsis, radiation therapy, and other concomitantly administered drugs associated with toxic epidermal necrolysis

Pregnancy category: B

Lactation: Drug is excreted in milk in low concentrations; use not recommended (American Academy of Pediatrics committee states that drug is compatible with nursing)

Adults

225 mg/day nebulized; 8 g/day IV/IM is FDA-approved; however, 12 g/day IV has been used.

Geriatric

225 mg/day nebulized; 8 g/day IV/IM is FDA-approved; however, 12 g/day IV has been used.

Adolescents

225 mg/day nebulized; 120 mg/kg/day (Max: 8 g/day) IV is the FDA-approved maximum dosage; however, up to 300 mg/kg/day (Max: 12 g/day) IV has been used in patients with cystic fibrosis.

Children

7 to 12 years: 120 mg/kg/day (Max: 8 g/day) IV is the FDA-approved maximum dosage; however, up to 300 mg/kg/day (Max: 12 g/day) IV has been used in patients with cystic fibrosis. The maximum nebulized dosage is 225 mg/day.
1 to 6 years: 120 mg/kg/day IV is the FDA-approved maximum dosage; however, up to 300 mg/kg/day IV has been used in patients with cystic fibrosis. Safety and efficacy of nebulization have not been established.

Infants

9 to 12 months: 120 mg/kg/day IV is the FDA-approved maximum dosage; however, up to 300 mg/kg/day IV has been used in patients with cystic fibrosis. Safety and efficacy of nebulization have not been established.
1 to 8 months: Safety and efficacy have not been established. Doses up to 120 mg/kg/day IV have been used off-label for most infections; up to 300 mg/kg/day IV has been used in patients with cystic fibrosis.

Neonates

34 weeks gestation and older and 8 days and older: Safety and efficacy have not been established; however, doses up to 120 mg/kg/day IV have been used off-label.
34 weeks gestation and older and 0 to 7 days: Safety and efficacy have not been established; however, doses up to 90 mg/kg/day IV have been used off-label.
Younger than 34 weeks gestation and 8 days and older: Safety and efficacy have not been established; however, doses up to 90 mg/kg/day IV have been used off-label.
Younger than 34 weeks gestation and 0 to 7 days: Safety and efficacy have not been established; however, doses up to 60 mg/kg/day IV have been used off-label.

Aztreonam

solution, inhalation

  • 75mg

powder for injection

  • 1g
  • 2g

inhalation solution

  • 75mg/single-use vial
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