Aztreonam

Indications
 Parenteral
Bone and joint infections
Adult: 1-8 g daily in divided doses every 6-12 hr by slow IV inj over 3-5 minutes or as IV infusion over 20-60 minutes. Max: 8 g/day. Dose may be given via deep IM inj or IV inj over 3-5 minutes or IV infusion.
Child: and infants >1 wk: 30 mg/kg every 6 or 8 hr; ≥2 yr: 50 mg/kg every 6 or 8 hr for severe infections. Dose may be given via deep IM inj or slow IV inj or infusion. Doses >1 g should be given via IV route. Max (≥2 yr): 8 g/day.
Renal impairment: Moderate-severe impairment: Same initial doses, adjust maintenance doses according to the patient's CrCl. Haemodialysis: A supplementary dose of 1/8 of the initial dose may be given after each session.
CrCl (ml/min)Dosage Recommendation
10-30Maintenance dose: Half of initial dose.
<10Maintenance dose: One-quarter of initial dose.

Parenteral
Gonorrhoea
Adult: 1-8 g daily in divided doses every 6-12 hr by slow IV inj over 3-5 minutes or as IV infusion over 20-60 minutes. Max: 8 g/day. Dose may be given via deep IM inj or IV inj over 3-5 minutes or IV infusion.
Child: and infants >1 wk: 30 mg/kg every 6 or 8 hr; ≥2 yr: 50 mg/kg every 6 or 8 hr for severe infections. Dose may be given via deep IM inj or slow IV inj or infusion. Doses >1 g should be given via IV route. Max (≥2 yr): 8 g/day.
Renal impairment: Moderate-severe impairment: Same initial doses, adjust maintenance doses according to the patient's CrCl. Haemodialysis: A supplementary dose of 1/8 of the initial dose may be given after each session.
CrCl (ml/min)Dosage Recommendation
10-30Maintenance dose: Half of initial dose.
<10Maintenance dose: One-quarter of initial dose.

Parenteral
Intra-abdominal infections
Adult: 1-8 g daily in divided doses every 6-12 hr by slow IV inj over 3-5 minutes or as IV infusion over 20-60 minutes. Max: 8 g/day. Dose may be given via deep IM inj or IV inj over 3-5 minutes or IV infusion.
Child: and infants >1 wk: 30 mg/kg every 6 or 8 hr; ≥2 yr: 50 mg/kg every 6 or 8 hr for severe infections. Dose may be given via deep IM inj or slow IV inj or infusion. Doses >1 g should be given via IV route. Max (≥2 yr): 8 g/day.
Renal impairment: Moderate-severe impairment: Same initial doses, adjust maintenance doses according to the patient's CrCl. Haemodialysis: A supplementary dose of 1/8 of the initial dose may be given after each session.
CrCl (ml/min)Dosage Recommendation
10-30Maintenance dose: Half of initial dose.
<10Maintenance dose: One-quarter of initial dose.

Parenteral
Lower respiratory tract infections
Adult: 1-8 g daily in divided doses every 6-12 hr by slow IV inj over 3-5 minutes or as IV infusion over 20-60 minutes. Max: 8 g/day. Dose may be given via deep IM inj or IV inj over 3-5 minutes or IV infusion.
Child: and infants >1 wk: 30 mg/kg every 6 or 8 hr; ≥2 yr: 50 mg/kg every 6 or 8 hr for severe infections. Dose may be given via deep IM inj or slow IV inj or infusion. Doses >1 g should be given via IV route. Max (≥2 yr): 8 g/day.
Renal impairment: Moderate-severe impairment: Same initial doses, adjust maintenance doses according to the patient's CrCl. Haemodialysis: A supplementary dose of 1/8 of the initial dose may be given after each session.
CrCl (ml/min)Dosage Recommendation
10-30Maintenance dose: Half of initial dose.
<10Maintenance dose: One-quarter of initial dose.

Parenteral
Meningitis
Adult: 1-8 g daily in divided doses every 6-12 hr by slow IV inj over 3-5 minutes or as IV infusion over 20-60 minutes. Max: 8 g/day. Dose may be given via deep IM inj or IV inj over 3-5 minutes or IV infusion.
Child: and infants >1 wk: 30 mg/kg every 6 or 8 hr; ≥2 yr: 50 mg/kg every 6 or 8 hr for severe infections. Dose may be given via deep IM inj or slow IV inj or infusion. Doses >1 g should be given via IV route. Max (≥2 yr): 8 g/day.
Renal impairment: Moderate-severe impairment: Same initial doses, adjust maintenance doses according to the patient's CrCl. Haemodialysis: A supplementary dose of 1/8 of the initial dose may be given after each session.
CrCl (ml/min)Dosage Recommendation
10-30Maintenance dose: Half of initial dose.
<10Maintenance dose: One-quarter of initial dose.

Parenteral
Septicaemia
Adult: 1-8 g daily in divided doses every 6-12 hr by slow IV inj over 3-5 minutes or as IV infusion over 20-60 minutes. Max: 8 g/day. Dose may be given via deep IM inj or IV inj over 3-5 minutes or IV infusion.
Child: and infants >1 wk: 30 mg/kg every 6 or 8 hr; ≥2 yr: 50 mg/kg every 6 or 8 hr for severe infections. Dose may be given via deep IM inj or slow IV inj or infusion. Doses >1 g should be given via IV route. Max (≥2 yr): 8 g/day.
Renal impairment: Moderate-severe impairment: Same initial doses, adjust maintenance doses according to the patient's CrCl. Haemodialysis: A supplementary dose of 1/8 of the initial dose may be given after each session.
CrCl (ml/min)Dosage Recommendation
10-30Maintenance dose: Half of initial dose.
<10Maintenance dose: One-quarter of initial dose.

Parenteral
Skin and soft tissue infections
Adult: 1-8 g daily in divided doses every 6-12 hr by slow IV inj over 3-5 minutes or as IV infusion over 20-60 minutes. Max: 8 g/day. Dose may be given via deep IM inj or IV inj over 3-5 minutes or IV infusion.
Child: and infants >1 wk: 30 mg/kg every 6 or 8 hr; ≥2 yr: 50 mg/kg every 6 or 8 hr for severe infections. Dose may be given via deep IM inj or slow IV inj or infusion. Doses >1 g should be given via IV route. Max (≥2 yr): 8 g/day.
Renal impairment: Moderate-severe impairment: Same initial doses, adjust maintenance doses according to the patient's CrCl. Haemodialysis: A supplementary dose of 1/8 of the initial dose may be given after each session.
CrCl (ml/min)Dosage Recommendation
10-30Maintenance dose: Half of initial dose.
<10Maintenance dose: One-quarter of initial dose.

Parenteral
Pelvic infections
Adult: 1-8 g daily in divided doses every 6-12 hr by slow IV inj over 3-5 minutes or as IV infusion over 20-60 minutes. Max: 8 g/day. Dose may be given via deep IM inj or IV inj over 3-5 minutes or IV infusion.
Child: and infants >1 wk: 30 mg/kg every 6 or 8 hr; ≥2 yr: 50 mg/kg every 6 or 8 hr for severe infections. Dose may be given via deep IM inj or slow IV inj or infusion. Doses >1 g should be given via IV route. Max (≥2 yr): 8 g/day.
Renal impairment: Moderate-severe impairment: Same initial doses, adjust maintenance doses according to the patient's CrCl. Haemodialysis: A supplementary dose of 1/8 of the initial dose may be given after each session.
CrCl (ml/min)Dosage Recommendation
10-30Maintenance dose: Half of initial dose.
<10Maintenance dose: One-quarter of initial dose.

Parenteral
Susceptible infections
Adult: 1-8 g daily in divided doses every 6-12 hr by slow IV inj over 3-5 minutes or as IV infusion over 20-60 minutes. Max: 8 g/day. Dose may be given via deep IM inj or IV inj over 3-5 minutes or IV infusion.
Child: and infants >1 wk: 30 mg/kg every 6 or 8 hr; ≥2 yr: 50 mg/kg every 6 or 8 hr for severe infections. Dose may be given via deep IM inj or slow IV inj or infusion. Doses >1 g should be given via IV route. Max (≥2 yr): 8 g/day.
Renal impairment: Moderate-severe impairment: Same initial doses, adjust maintenance doses according to the patient's CrCl. Haemodialysis: A supplementary dose of 1/8 of the initial dose may be given after each session.
CrCl (ml/min)Dosage Recommendation
10-30Maintenance dose: Half of initial dose.
<10Maintenance dose: One-quarter of initial dose.

Intramuscular
Gonorrhoea
Adult: 1 g as a single dose.
Renal impairment: Moderate-severe impairment: Same initial doses, adjust maintenance doses according to the patient's CrCl. Haemodialysis: A supplementary dose of 1/8 of the initial dose may be given after each session.
CrCl (ml/min)Dosage Recommendation
10-30Maintenance dose: Half of initial dose
<10Maintenance dose: One-quarter of initial dose

Intramuscular
Cystitis
Adult: 1 g as a single dose.
Renal impairment: Moderate-severe impairment: Same initial doses, adjust maintenance doses according to the patient's CrCl. Haemodialysis: A supplementary dose of 1/8 of the initial dose may be given after each session.
CrCl (ml/min)Dosage Recommendation
10-30Maintenance dose: Half of initial dose
<10Maintenance dose: One-quarter of initial dose

Parenteral
Urinary tract infections
Adult: 0.5-1 g every 8-12 hr. Dose may be given via deep IM inj or IV inj over 3-5 minutes or IV infusion.

Incompatibility: Incompatible with cefradine, metronidazole, nafcillin and vancomycin.
Contraindications
 Hypersensitivity; lactation.
Warnings / Precautions
 Hypersensitivity to other β-lactams; renal and hepatic impairment; pregnancy.
Adverse Reactions
 IV: Phloebitis and thrombophloebitis. IM: Pain and swelling at inj site; diarrhoea, nausea, vomiting, altered taste; jaundice, hepatitis, high liver enzymes; long prothrombin time, partial thromboplastin time; rash, urticaria, eosinophilia.
Potentially Fatal: Thrombocytopenia, neutropenia; overgrowth of susceptible organisms; pseudomembranous colitis.
Overdose Reactions
 If needed, haemodialysis and/or peritoneal dialysis may be used to remove drug from serum.
Drug Interactions
 Concurrent use with oral anticoagulants may increase prothrombin time.
See Below for More aztreonam Drug Interactions
Lab Interactions
 Intereferes with urine glucose test using cupric sulfate. False-positive with Coomb's test.
Mechanism of Actions
 Aztreonam exhibits bactericidal action by inhibiting bacterial cell wall synthesis due to its high affinity for penicillin-binding protein 3 (PBP-3) of gram-negative bacteria. It is highly resistant to hydrolysis by β-lactamases. It is active against Enterobacteriaceae spp, E. coli, Klebsiella, Proteus, Providencia, Salmonella, Serratia, Shigella and Yersinia spp..
Absorption: Absorbed poorly from the GI tract (oral).
Distribution: Body tissues and fluids (wide), bile, CSF (especially in the presence of meningitis), crosses the placenta and enters breast milk. Protein-binding: 56%.
Metabolism: Minimal metabolism; SQ-26992 (primary metabolite, inactive).
Excretion: Via urine by renal tubular secretion and glomerular filtration (60-70% as unchanged), via faeces (small amounts of unchanged drug and metabolites); 1.7 hr (elimination half-life). Removed by dialysis and peritoneal dialysis (lesser extent).
Storage Conditions
 Intramuscular: Once reconstituted, it should be used within 48 hr if stored at 15-30°C or 7 days if stored at 2-8°C. Parenteral: Once reconstituted, it should be used within 48 hr if stored at 15-30°C or 7 days if stored at 2-8°C.
ATC Classification
 J01DF01 - aztreonam ; Belongs to the class of monobactams. Used in the systemic treatment of infections.
Storage
 Intramuscular: Once reconstituted, it should be used within 48 hr if stored at 15-30°C or 7 days if stored at 2-8°C. Parenteral: Once reconstituted, it should be used within 48 hr if stored at 15-30°C or 7 days if stored at 2-8°C.
Available As
  • Aztreonam 1000 mg
  • Aztreonam 2000 mg
  • Aztreonam 250 mg
  • Aztreonam 500 mg

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