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ANTIINFECTIVES FOR SYSTEMIC USE › ANTIBACTERIALS FOR SYSTEMIC USE › OTHER BETA-LACTAM ANTIBACTERIALS › Monobactams
aztreonam
J01DF01
Forms & Strengths
- Injection: 500 mg, 1 g, 2 g single-dose vials
- Inhalation solution: 75 mg/mL (Cayston)
Adult Dosing
- Urinary tract infections: 500 mg to 1 g IV/IM every 8 to 12 hours
- Moderate to severe systemic infections: 1 to 2 g IV/IM every 8 to 12 hours
- Severe systemic or life-threatening infections: 2 g IV every 6 to 8 hours
- Cystic fibrosis pulmonary exacerbations (inhalation): 75 mg nebulized three times daily for 28 days
Pediatric Dosing
- Pediatric patients >1 month (mild to moderate infections): 30 mg/kg IV/IM every 8 hours
- Pediatric patients >1 month (severe infections/cystic fibrosis): 50 mg/kg IV every 6 to 8 hours (max 8 g/day)
- Cystic fibrosis pulmonary exacerbations (inhalation, age >=7 years): 75 mg nebulized three times daily for 28 days
Indications
- Urinary tract infections caused by susceptible gram-negative aerobic bacilli
- Lower respiratory tract infections caused by susceptible gram-negative organisms
- Septicemia caused by susceptible gram-negative pathogens
- Skin and skin structure infections caused by susceptible gram-negative bacteria
- Intra-abdominal infections caused by susceptible gram-negative bacteria
- Gynecologic infections caused by susceptible gram-negative organisms
- Improvement of pulmonary symptoms in cystic fibrosis patients with Pseudomonas aeruginosa
Mechanism of Action
- Monobactam antibacterial that inhibits bacterial cell wall synthesis
- Binds preferentially to penicillin-binding protein 3 (PBP3) of susceptible gram-negative aerobic bacteria
- Highly resistant to hydrolysis by most beta-lactamases (both penicillinases and cephalosporinases)
- Lacks significant activity against gram-positive organisms and anaerobes
Contraindications
- Known hypersensitivity to aztreonam or any component of the formulation
Adverse Reactions
- Diarrhea
- Nausea and vomiting
- Rash and localized skin reactions
- Elevated serum transaminases and alkaline phosphatase
- Phlebitis and thrombophlebitis at injection site
- Candidiasis (oral and vaginal)
- Clostridioides difficile-associated diarrhea
Drug Interactions
- Beta-lactamase inducers (e.g., cefoxitin, imipenem) may antagonize the antibacterial activity of aztreonam
- Probenecid may decrease the renal tubular secretion of aztreonam, increasing serum concentrations
- Aminoglycosides may exhibit synergistic or additive activity against certain gram-negative bacilli (e.g., Pseudomonas aeruginosa)
- May increase the anticoagulant effect of warfarin
Curated Content: Needs Vetting Before Put to Clinical Use