II. Indications
-
Gram Negative aerobic Bacterial Infections
- Urinary Tract Infections
- Intraabdominal and gynecologic infections
- Pseudomonas aeruginosa infections
- Cystic Fibrosis respiratory symptoms (nebulized Cayston)
III. Mechanism
- Classified as a Monobactam
- Monocyclic beta-lactam Antibiotic originally isolated from Chromobacterium violaceum
- Binds to and inactivates Penicillin-binding Protein-3 (PBP-3)
- Inhibits cross-linking of Bacterial cell wall components (similar to Carbapenems)
- Activity against Gram Negative Bacteria (including Pseudomonas aeruginosa)
- No significant Gram Positive activity
- Wide tissue distribution (includes joints, CNS and urine)
IV. Dosing: Adult
-
Urinary Tract Infection
- Give 0.5 to 1 gram IM or IV every 8 to 12 hours
- Moderate Gram Negative Infections (e.g. intraabdominal, gynecologic)
- Give 1 to 2 grams IM or IV every 8 to 12 hours
- Severe Gram Negative Infections or Pseudomonas Infections
- Give 2 grams IV every 6 to 8 hours
-
Cystic Fibrosis Respiratory Symptoms
- Nebulize 1 Cayston vial (75 mg) three times daily for 28 days (then hold for at least 28 days)
- Given only with Altera nebulizer, after both Bronchodilator and mucolytic
- Administer after Bronchodilator - short acting (15 min to 4 h) or long-acting (30 min to 12 h)
-
Renal Dosing (eGFR <30 ml/min)
- eGFR 10 to 30 ml/min: Give 1 to 2 g IV load, then give 50% of typical dose
- eGFR <10: Give 0.5 to 2 g IV load, then give 25% of typical dose
- Hemodialysis (life threatening infections)
- Give 12.5% of typical dose after each Hemodialysis run
V. Dosing: Child
-
Gram Negative Infections
- Give 30 mg/kg IV every 6 to 8 hours
-
Cystic Fibrosis Respiratory Symptoms (age >= 7 years old)
- Nebulize 1 Cayston vial (75 mg) three times daily for 28 days (then hold for at least 28 days)
- Given only with Altera nebulizer, after both Bronchodilator and mucolytic
- Administer after Bronchodilator - short acting (15 min to 4 h) or long-acting (30 min to 12 h)
-
Pseudomonas respiratory infection in Cystic Fibrosis (not FDA approved)
- Give 50 mg/kg IV every 6 to 8 hours
VI. Adverse Effects
- Intravenous formulation
- Hypersensitivity
- Gastrointestinal upset
- Seizures
- Hepatitis
- Gastrointestinal upset
- Nebulized Formulation
- Bronchospasm
- Cough
- Nasal congestion
- Wheezing
- Pharyngitis
- Chest Pain
- Vomiting
- Serious
VII. Safety
- Pregnancy Category B
- Safe in Lactation
VIII. Resources
- Aztreonam (DailyMed)
- Cayston Aztreonam Nebulizer Solution (DailyMed)
IX. References
- (2010) Med Lett Drugs Ther 52(1344): 63-4
- Hamilton (2020) Tarascon Pocket Pharmacopoeia
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Related Studies
Definition (NCI) | A monocyclic beta-lactam antibiotic originally isolated from Chromobacterium violaceum with bactericidal activity. Aztreonam preferentially binds to and inactivates penicillin-binding protein-3 (PBP-3), which is involved in bacterial cell wall synthesis, thereby inhibiting bacterial cell wall integrity and leading to cell lysis and death. This agent differs from other beta-lactam antibiotics because it is resistant to beta-lactamase hydrolysis, and it is usually used to treat infections caused by gram-negative aerobic microorganisms. |
Definition (MSH) | A monocyclic beta-lactam antibiotic originally isolated from Chromobacterium violaceum. It is resistant to beta-lactamases and is used in gram-negative infections, especially of the meninges, bladder, and kidneys. It may cause a superinfection with gram-positive organisms. |
Concepts | Antibiotic (T195) , Organic Chemical (T109) |
MSH | D001398 |
SnomedCT | 391808003, 387386004, 69918003 |
LNC | LP16041-3, MTHU006798 |
English | Az threonam, Az-threonam, Azthreonam, Aztreonam, Propanoic acid, 2-(((1-(2-amino-4-thiazolyl)-2-((2-methyl-4-oxo-1-sulfo-3-azetidinyl)amino)-2-oxoethylidene)amino)oxy)-2-methyl-, (2S-(2alpha,3beta(Z)))-, aztreonam, aztreonam (medication), Aztreonam [Chemical/Ingredient], AZTREONAM, Aztreonam - chemical, Aztreonam - chemical (substance), Aztreonam (product), Aztreonam (substance) |
Swedish | Aztreonam |
Czech | aztreonam |
Finnish | Atstreonaami |
Italian | Az-treonam, Aztreonam |
Russian | AZTREONAM, АЗТРЕОНАМ |
Japanese | アズトレオナム |
French | Aztréonam |
Polish | Aztreonam |
Spanish | aztreonam (producto), aztreonam (sustancia), aztreonam, Aztreonam |
German | Aztreonam |
Portuguese | Aztreonam |