Aztreonam
General
- Type: Monobactam
- Dosage forms: IM; IV
- Common Trade Names: Azactam
Other
- Antimicrobial activity more closely resembles AG's (only active against gram -)
- Enterobacter, pseudomonas, H. influenzae, gonococci
- Little allergic cross-reactivity with B-lactam antibiotics
Adult Dosing
General (Moderate Severe)
- 1-2g IM/IV q8-12h
- Max: 8g/day
General (Severe)
- 2g IM/IV q6-8h
- Max: 8g/day
Pediatric Dosing
General (Neonates)
- <7 days old
- <2000g
- 60 mg/kg/day IV divided q12h
- First ED Dose: 30 mg/kg x 1
- >2000g
- 90 mg/kg/day IV divided q8
- First ED Dose: 30 mg/kg x 1
- <2000g
- 7 days - 1 month
- <1200g
- 60 mg/kg/day IV divided q12h
- First ED Dose: 30 mg/kg x 1
- 1200-2000g
- 90 mg/kg/day IV divided q8
- First ED Dose: 30 mg/kg x 1
- >2000g
- 120 mg/kg/day IV divided q6
- First ED Dose: 30 mg/kg x 1
- <1200g
General (1 Month - 9 Months)
- General
- 90-120 mg/kg/day IV divided q6-8h
- First ED Dose: 40 mg/kg x 1
- Respiratory Infections in Cystic Fibrosis
- 200mg/kg/day IV divided q6h
- First ED Dose: 40 mg/kg x 1
- Max: 8g/day
General >9 Months)
- 90-120 mg/kg/day IV divided q6-8
- First ED Dose: 40 mg/kg x 1
Special Populations
- Pregnancy: B
- Lactation: Safe
- Renal
- Adult
- CrCl 10-30: 1-2g x1, then decrease dose 50%
- CrCl <10: give usual dose x1, then decrease dose 75%
- Hemodialysis: give 12.5% of initial dose as supplement
- Peritoneal dialysis: no supplement
- Pediatric
- CrCl 10-30: decrease dose 50%
- CrCl <10: decrease dose 75%
- Hemodialysis: give supplement
- Peritoneal dialysis: no supplement
- Adult
- Hepatic (Adult & Pediatric)
- caution advised, but not defined
Contraindications
- Allergy to class/drug
Adverse Drug Reactions
Serious
- Anaphylaxis
- Allergic Reaction
- Toxic Epidermal Necrolysis
- Seizures
- C diff
- Hepatitis
- Neutropenia
- Thrombocytopenia
- Anemia
Common
- Phlebitis
- Injection site reaction
- Diarrhea
- Nausea/vomiting
- Rash
- Transaminitis
- Elevated creatinine
- Eosinophilia
Pharmacology
- Half-life: 1.7h (4.7-6h ESRD)
- Metabolism: CYP450, minimal liver
- Excretion: Urine
- Mechanism of Action: Bactericidal; inhibits cell wall synthesis
Antibacterial Spectra
Gram Positives | Susceptibility |
---|---|
Strep, Group A, B, C, G | 0 |
Strep. pneumoniae | 0 |
Viridans strep | 0 |
Strep. milleri | 0 |
Enterococcus faecalis | 0 |
Enterococcus faecium | 0 |
Staph. aureus (MSSA) | 0 |
Staph. aureus (MRSA) | 0 |
Staph. aureus (CA-MRSA) | 0 |
Staph. epidermidis | 0 |
C. jeikeium | 0 |
L. monocytogenes | 0 |
- + usually effective clinically or >60% susceptible
- +/- clinical trials lacking or 30-60% susceptible
- 0 not effective clinically or <30% susceptible
- blank data not available
See Also
Source
- Epocrates