Aztreonam

Aztreonam is a prescription medication used to treat Systemic Infections, Pseudomonal Infections, Urinary Tract Infections, and Cystic fibrosis. 

• Aztreonam is available under the following different brand names: Azactam.

Adult and pediatric dosage

Solution, inhalation

• 75mg

Powder for injection

• 1g
• 2g

Systemic Infections

Adult dosage

• Moderately severe: 1-2 g IV/IM every 8-12 hours; not to exceed 8 g/day
• Severe or life-threatening: 2 g IV/IM every 6-8 hours; not to exceed 8 g/day

Pediatric dosage

Mild-to-Moderate Infections

• Children younger than 9 months of age: Safety and efficacy not established
• Children older than 9 months of age: 30 mg/kg IV every 8 hours; not to exceed 120 mg/kg/day

Moderate-to-Severe Infections

• Children younger than 9 months of age: Safety and efficacy not established
• Children older than 9 months of age: 30 mg/kg IV every 6-8 hours; not to exceed 120 mg/kg/day

Pseudomonal Infections

Adult dosage

• 2 g IV/IM every 6-8 hours; not to exceed 8 g/day

Urinary Tract Infections

Adult dosage

• 0.5-1g IV/IM every 8-12 hours; not to exceed 8 gram/day

Cystic fibrosis

Adult dosage

• 75 mg via nebulizer every 8 hours for 28 days; at least 4 hours apart; not to be repeated for another 28 days after completion; pretreatment with broncdilator recommended

Pediatric dosage

• Children younger than 9 months of age: Safety and efficacy not established
• Children older than 9 months of age: 50 mg/kg IV every 6-8 hours; not to exceed 200 mg/kg/day; not to exceed 8 g/day
• Children older than 7 years of age: 75 mg via nebulizer three times daily, at least 4 hours apart, for 28 days; not to be repeated for another 28 days

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”.

Common side effects of Aztreonam include:

• nausea,
• vomiting, 
• diarrhea, 
• rash, 
• vaginal itching or discharge, and
• pain, bruising, swelling, or irritation where the medicine was injected

Serious side effects of Aztreonam include:

• hives, 
• difficulty breathing, 
• swelling of the face or throat, 
• fever, 
• sore throat, 
• burning eyes, 
• skin pain, 
• red or purple skin rash with blistering and peeling, 
• severe stomach pain, 
• diarrhea that is watery or bloody, 
• wheezing, 
• chest pain, 
• easy bruising, 
• unusual bleeding, 
• seizure, 
• loss of appetite, 
• stomach pain (upper right side), 
• dark urine, 
• clay-colored stools, and
• yellowing of the skin or eyes (jaundice)

Rare side effects of Aztreonam include:

• none 

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them.  Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first

• Aztreonam has severe interactions with no other drugs. 
• Aztreonam has serious interactions with the following drugs:
  • BCG vaccine live
  • cholera vaccine
  • typhoid vaccine live
• Aztreonam has moderate interactions with the following drugs:
  • bazedoxifene/conjugated estrogens
  • cefoxitin
  • conjugated estrogens
  • dienogest/estradiol valerate
  • digoxin
  • estradiol
  • estrogens conjugated synthetic
  • estropipate
  • mestranol
  • sodium picosulfate/magnesium oxide/anhydrous citric acid
• Aztreonam has minor interactions with at least 22 other drugs.

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drugs interactions. Therefore, before using this drug, tell your doctor or pharmacist of all the drugs you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist. Check with your physician if you have health questions or concerns.

Contraindications

• Hypersensitivity 

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Aztreonam?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Aztreonam?”

Cautions

• In patients with impaired hepatic or renal function, appropriate monitoring is recommended during therapy
• If an 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 occurs during therapy
• Rare cases of toxic epidermal necrolysis were 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

Clostridium difficile–associated diarrhea (CDAD)

• Reported with use of nearly all antibacterial agents and may range in severity from mild diarrhea to fatal colitis; treatment with antibacterial agents alters the normal flora of the colon leading to overgrowth of C. difficile
• If CDAD is suspected or confirmed, ongoing antibiotic use not directed against C. difficile may need to be discontinued; appropriate fluid and electrolyte management, protein supplementation, antibiotic treatment of C. difficile, and surgical evaluation should be instituted as clinically indicated

Pregnancy and Lactation

• May be acceptable during pregnancy. 
• Lactation: Drug is excreted in milk in low concentrations; use not recommended (American Academy of Pediatrics committee states that drug is compatible with nursing)