Aztreonam for injection
Aztreonam for injection (Azactam for Injection)
Aztreonam for injection
(as- TREE-oh-nam)
Pregnancy Category: B Azactam for Injection (Rx)

Classification: Monobactam antibiotic

See Also: See also Anti-Infectives.

Action/Kinetics: Synthetic monobactam antibiotic. It is bactericidal against gram-negative aerobic pathogens. Acts by inhibiting cell wall synthesis due to a high affinity of the drug for penicillin binding protein 3; this results in cell lysis and death. Widely distributed to all body fluids. Time to peak serum levels: 0.6-1.3 hr. t 1/2: 1.5-2 hr. (prolonged in clients with impaired renal function). Approximately 60%-75% excreted unchanged in the urine within 8 hr.

Uses: (1) Complicated and uncomplicated urinary tract infections (including pyelonephritis and cystitis) due to Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Pseudomonas aeruginosa, Enterobacter cloacae, Klebsiella oxytoca, Citrobacter species, and Serratia marcescens. (2) Lower respiratory tract infections (including bronchitis and pneumonia) due to E. coli, K. pneumoniae, P. aeruginosa, Hemophilus influenzae, P. mirabilis, Enterobacter species, and S. marcescens. (3) Septicemia due to E. coli, K. pneumoniae, P. aeruginosa, P. mirabilis, S. marcescens and Enterobacter species. (4) Skin and skin structure infections (including postoperative wounds, ulcers, and burns) caused by E. coli, P. mirabilis, S. marcescens, Enterobacter species, P. aeruginosa, K. pneumoniae, and Citrobacter species. (5) Intra-abdominal infections (including peritonitis) due to E. coli, Klebsiella species including K. pneumoniae Enterobacter species including E. cloacae, P. aeruginosa, Citrobacter species including C. freundii, and Serratia species including S. marcescens. (6) Gynecologic infections (including endometritis and pelvic cellulitis) due to E. coli, K. pneumoniae, P. mirabilis and Enterobacter species including E. cloacae.
As an adjunct to surgery to manage infections caused by susceptible organisms. As an alternative to spectinomycin in clients with acute uncomplicated gonorrhea who are resistant to penicillin. Concomitant initial therapy with other anti-infective drugs and aztreonam in seriously ill clients is recommended before the causative organism is known and who are at risk for an infection due to gram-positive aerobic pathogens.

Contraindications: Allergy to aztreonam. Lactation.

Special Concerns: Safety and effectiveness have not been determined in infants less than 9 months of age or for use in children with septicemia or skin and skin-structure infections where the skin infection is due to H. influenzae type b. Use with caution in clients allergic to penicillins or cephalosporins and in those with impaired hepatic or renal function.

Side Effects: GI: N&V;, diarrhea, abdominal cramps, mouth ulcers, numb tongue, halitosis pseudomembranous colitis, Clostridium difficile-associated diarrhea or GI bleeding. CNS: Confusion, seizures vertigo, headache, paresthesia, insomnia, dizziness. Hematologic: Anemia, neutropenia, thrombocytopenia, leukocytosis, thrombocytosis, pancytopenia, eosinophilia. Dermatologic: Rash, purpura, erythema multiforme, urticaria, petechiae, pruritus, diaphoresis, exfoliative dermatitis, toxic epidermal necrolysis. CV: Hypotension, transient ECG changes, flushing. Following parenteral use: Phlebitis and thrombophlebitis after IV use; discomfort and swelling at the injection site after IM use. Allergic: Anaphylaxis angioedema, bronchospasm. Miscellaneous: Superinfection, weakness, fever, malaise, hepatitis, jaundice, muscle aches, tinnitus, diplopia, nasal congestion, altered taste, sneezing, vaginal candidiasis, vaginitis, breast tenderness, chest pain, dyspnea, wheezing.

Laboratory Test Alterations: AST, ALT, alkaline phosphatase, serum creatinine, PT, PTT. Positive Coombs' test. Hepatobiliary dysfunction.

Overdose Management: Treatment: Hemodialysis or peritoneal dialysis to reduce serum levels.

Drug Interactions: Aminoglycosides / Risk of nephrotoxicity and ototoxicity Cefoxitin / Inhibits aztreonam activity Imipenem / Inhibits aztreonam activity

How Supplied: Powder for injection (lyophilized cake): 500 mg, 1 g, 2 g

Dosage
?IM, IV Urinary tract infections.
Adults: 0.5-1 g q 8-12 hr, not to exceed 8 g/day.
Mild to moderate infections in children.
Children: 30 mg/kg q 8 hr, not to exceed 120 mg/kg/day.
Moderate to severe systemic infections.
Adults:1-2 g q 8-12 hr, not to exceed 8 g/day. Children: 30 mg/kg q 6- 8 hr, not to exceed 120 mg/kg/day.
Severe systemic or life-threatening infections.
2 g q 6-8 hr, not to exceed 8 g/day.
P. aeruginosa infections in children.
50 mg/kg q 4-6 hr.
NOTE: Dose must be reduced in clients with impaired renal function.