Aztreonam
Mechanism :
Originally isolated from Chromobacterium violaceum, it is a synthetic bactericidal antibiotic. Aztreonam exhibits potent and specific activity in vitro against a wide spectrum of gram-negative aerobic pathogens including Pseudomonas aeruginosa. The bactericidal action of aztreonam is due to the inhibition of bacterial cell wall synthesis.
Indication :
- Lower respiratory tract infections
- Urinary tract infection
- Septicemia
- Skin and soft tissue infections
- Intra-abdominal Infections
Contraindications :
This preparation is contraindicated in patients with known hypersensitivity to aztreonam or any other component in the formulation.
Dosing :
<9 months: Safety and Efficacy not established.
>9 months: IV: 30 mg/kg 6-8 hourly, maximum dose: 120 mg/kg/day.
Cystic Fibrosis:
>9 months: IV 50 mg/kg every 6-8 hours; maximum dose: 200 mg/kg/day; do not exceed 8 g/day.
>7 years: 75 mg thrice daily via nebulizer, at least 4 hours apart for 28 days; do not repeat for another 1 month.
Adverse Effect :
Hypersensitivity (anaphylaxis, angioedema, bronchospasm), pancytopenia, neutropenia, thrombocytopenia, anemia, eosinophilia, leucocytosis, thrombocytosis, abdominal cramps, pseudomembranous colitis, toxic epidermal necrolysis, erythema multiforme, exfoliative dermatitis, urticaria, petechiae, pruritus, diaphoresis, hypotension, transient ECG changes, wheezing, dyspnea, chest pain, hepatitis, jaundice, seizure, confusion, vertigo, paresthesia, insomnia, dizziness.
Interaction :
Avoid using antibiotics that induce beta-lactamase production (cefoxitin, imipenem); probenecid and furosemide increases aztreonam serum levels.
Renal Dose :
Dose in Renal Impairment GFR (mL/min)
30-50 | Dose as in normal renal function |
10-30 | 1–2 g loading dose, then maintenance of 50% of appropriate normal dose |
<10 | 1–2 g loading dose, then maintenance of 25% of appropriate normal dose |
Dose in Patients undergoing Renal Replacement Therapies
CAPD | Not dialysed. Dose as in GFR<10 mL/min |
HD | Dialysed. Dose as in GFR<10 mL/ min |
HDF/High flux | Dialysed. Dose as in GFR<10 mL/ min |
CAV/VVHD | Dialysed. Loading dose of 2 g then 1–2 g every 12 hours |
CVVHD/HDF | Dialysed. 2 g every 12 hours |
Hepatic Dose :
No dosage adjustments are recommended.