Generic Name: Aztreonam Brand Name(s): Generics only. No brands available. Avability: Rx Pregnancy Category: B

Uses

What is Aztreonam used for?

Aztreonam is used to treat a wide variety of bacterial infections. This medication is an antibiotic that works by stopping the growth of bacteria.

How should I take Aztreonam?

This medication is usually given by injection into a vein or a muscle as directed by your doctor. The dosage is based on your medical condition and response to therapy.

If you are giving this medication to yourself at home, learn all preparation and usage instructions from your health care professional. Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid. Learn how to store and discard medical supplies safely.

For the best effect, use this antibiotic at evenly spaced times. To help you remember, use this medication at the same time(s) every day.

Continue to use aztreonam until the full prescribed amount is finished, even if symptoms disappear after a few days. Stopping the medication too early may allow bacteria to continue to grow, which may result in a relapse of the infection.

Tell your doctor if your condition persists or worsens.

How do I store Aztreonam?

Store in original packages at 20° to 25°C; avoid excessive heat. Store the powder and diluent in the refrigerator, do not freeze. Store the powder and diluent in the refrigerator, do not freeze.

After taking the powder and diluent out of the refrigerator, you may store them at room temperature away from moisture, heat, and light. This medicine must be used within 28 days if you keep it at room temperature.

There may be different brands of Aztreonam that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush Aztreonam down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using Aztreonam?

Before using aztreonam, tell your doctor or pharmacist if you are allergic to it; or to penicillins, cephalosporins, or certain other antibiotics (e.g., imipenem, meropenem); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney disease, liver disease.

This drug may rarely make you dizzy. Alcohol or marijuana can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana.

Aztreonam may cause live bacterial vaccines (such as typhoid vaccine) to not work as well. Do not have any immunizations/vaccinations while using this medication unless your doctor tells you to.

This medication should be used only when clearly needed during pregnancy. Discuss the risks and benefits with your doctor.

This medication passes into breast milk in small amounts. While there have been no reports of harm to nursing infants, consult your doctor before breast-feeding.

Is it safe during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using this Aztreonam during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking Aztreonam. Aztreonam is pregnancy risk category B according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk,
  • B=No risk in some studies,
  • C=There may be some risk,
  • D=Positive evidence of risk,
  • X=Contraindicated,
  • N=Unknown

Side effects

What side effects can occur from Aztreonam?

Diarrhea, nausea, vomiting, dizziness, headache, blurred vision, or redness/discomfort/pain/swelling at the injection site may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including: fast/irregular heartbeat, confusion, easy bruising/bleeding, ringing in the ears, seizures, chest pain, yellowing eyes or skin, dark urine, severe stomach/abdominal pain, persistent nausea or vomiting, unusual fatigue, persistent signs of infection (e.g., fever, sore throat).

This medication may rarely cause a severe intestinal condition (Clostridium difficile-associated diarrhea) due to a resistant bacteria. This condition may occur during treatment or weeks to months after treatment has stopped. Do not use anti-diarrhea or opioid medications if you have the following symptoms because these products may make them worse. Tell your doctor right away if you develop: persistent diarrhea, abdominal or stomach pain/cramping, blood/mucus in your stool..

Use of this medication for prolonged or repeated periods may result in oral thrush or a new vaginal yeast infection (oral or vaginal fungal infection), or a new type of bacterial infection. Contact your doctor if you notice white patches in your mouth, a change in vaginal discharge, or other new symptoms.

A very serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction may include: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Aztreonam?

Some products that may interact with this drug include: cefoxitin, imipenem.

Although most antibiotics are unlikely to affect hormonal birth control such as pills, patch, or ring, a few antibiotics (such as rifampin, rifabutin) can decrease their effectiveness. This could result in pregnancy. If you use hormonal birth control, ask your doctor or pharmacist for more details.

Aztreonam may cause false positive results with some diabetic urine testing products (cupric sulfate-type). Consult your doctor or pharmacist for recommendations. Make sure laboratory personnel and your doctors know you use this drug.

Aztreonam may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Does food or alcohol interact with Aztreonam?

Aztreonam may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Aztreonam?

Aztreonam may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this Aztreonam.

What is the dose of Aztreonam for an adult?

Usual Adult Dose for Bacteremia

2 g IV every 6 to 8 hours

Therapy should be continued for approximately 10 to 14 days, depending on the nature and severity of the infection.

Usual Adult Dose for Bacterial Infection

Moderately severe infections: 1 to 2 g IV or IM every 8 to 12 hours

Severe infections: 2 g IV every 6 to 8 hours (maximum, 8 g/day)

Usual Adult Dose for Cystic Fibrosis

Inhalation:

Initial dose: 75 mg via nebulizer over approximately 2 to 3 minutes 3 times a day for 28 days; doses should be at least 4 hours apart

Maintenance dose: Administer in alternating cycles of 28 days on and 28 days off.

For patients on multiple inhaled therapies, the following order of administration is recommended: bronchodilator, mucolytics, and lastly, aztreonam for inhalation.

Usual Adult Dose for Febrile Neutropenia

2 g IV every 6 to 8 hours

Therapy should be continued until the absolute neutrophil count is greater than 500/mm3 and no infection is found or until an adequate clinical response is achieved if a susceptible infection is found and the patient has been afebrile for at least 24 hours. Therapy for neutropenic patients is often required for up to 3 weeks.

Usual Adult Dose for Intraabdominal Infection

1 to 2 g IV every 8 or 12 hours

For severe or life-threatening infections, a dose of 2 g IV every 6 to 8 hours is recommended. Therapy should be continued for approximately 10 to 14 days, depending on the nature and severity of the infection.

Usual Adult Dose for Peritonitis

1 to 2 g IV every 8 or 12 hours

For severe or life-threatening infections, a dose of 2 g IV every 6 to 8 hours is recommended. Therapy should be continued for approximately 10 to 14 days, depending on the nature and severity of the infection.

Usual Adult Dose for Osteomyelitis

1 to 2 g IV every 8 or 12 hours

For severe or life-threatening infections, a dose of 2 g IV every 6 to 8 hours is recommended. Therapy should be continued for approximately 4 to 6 weeks, depending on the nature and severity of the infection. Chronic osteomyelitis may require an additional 2 months of oral antibiotics.

Usual Adult Dose for Pelvic Inflammatory Disease

1 to 2 g IV every 8 or 12 hours

For severe or life-threatening infections, a dose of 2 g IV every 6 to 8 hours is recommended. Therapy should be continued until this patient is afebrile and pain-free for 24 to 36 hours.

Usual Adult Dose for Pneumonia

1 to 2 g IV every 8 or 12 hours

For severe or life-threatening infections, a dose of 2 g IV every 6 to 8 hours is recommended. Therapy should be continued for approximately 21 days, depending on the nature and severity of the infection.

Usual Adult Dose for Pyelonephritis

1 to 2 g IV every 8 or 12 hours

For severe or life-threatening infections, a dose of 2 g IV every 6 to 8 hours is recommended. Therapy should be continued for approximately 14 days, depending on the nature and severity of the infection.

Usual Adult Dose for Skin or Soft Tissue Infection

1 to 2 g IV every 8 or 12 hours

For severe or life-threatening infections, a dose of 2 g IV every 6 to 8 hours is recommended. Therapy should be continued for approximately 7 days or until 3 days after acute inflammation disappears. For more severe infections, such as diabetic soft tissue infections, 14 to 21 days of therapy may be required.

Usual Adult Dose for Urinary Tract Infection

500 mg to 1 g IV or IM every 8 to 12 hours

Renal Dose Adjustments

Parenteral:

CrCl 10 to 30 mL/min: Loading dose of 1 to 2 g IV followed by one-half of the normal dose at the usual dosage interval

CrCl 9 mL/min or less: Loading dose of 500 mg to 2 g IV followed by one-fourth of the normal dose at the usual dosage interval

Inhalation:

No adjustment recommended.

Liver Dose Adjustments

No adjustment recommended.

Dose Adjustments

Because of the serious nature of infections due to Pseudomonas Aeruginosa, dosage of 2 g IV every 6 to 8 hours is recommended, at least upon initiation of therapy, in systemic infections caused by this organism.

Precautions

Serious and occasionally fatal hypersensitivity reactions have been reported with antibiotics. The drug should be discontinued immediately at the first appearance of skin rash or other signs of hypersensitivity and treatment should be initiated as appropriate. Severe, acute hypersensitivity reactions may require treatment with epinephrine and other resuscitative measures including oxygen, intravenous fluids, antihistamines, corticosteroids, cardiovascular support and airway management as clinically indicated.

Clostridium difficile associated diarrhea (CDAD) has been reported with almost all antibiotics and may potentially be life-threatening. Therefore, it is important to consider this diagnosis in patients who present with diarrhea following aztreonam therapy. Mild cases generally improve with discontinuation of the drug, while severe cases may require supportive therapy and treatment with an antimicrobial agent effective against C difficile. Hypertoxin producing strains of C difficile cause increased morbidity and mortality; these infections can be resistant to antimicrobial treatment and may necessitate colectomy.

Patients with renal or hepatic impairment should be monitored during therapy. Renal, hepatic, and hematopoietic monitoring is recommended periodically during prolonged therapy.

Renal function should be monitored, especially in elderly patients.

Safety and effectiveness of aztreonam for inhalation have not been established in patients with forced expiratory volume in 1 second (FEV1) less than 25% or greater than 75% predicted or in patients colonized with Burkholderia cepacia.

Dialysis

Parenteral: For serious or life-threatening infections, in addition to the maintenance doses, one-eighth of the initial dose should be given after each hemodialysis.

Inhalation: No adjustment recommended.

Other Comments

The maximum recommended parenteral dose is 8 g/day.

If necessary, doses of 1 g or less may be given intramuscularly in moderately severe infections; however, IM administration may be a problem for patients with end-stage renal disease if there is an underlying coagulopathy.

The IV route is recommended for patients requiring single doses greater than 1 g or those with bacterial septicemia, localized parenchymal abscess (e.g., intraabdominal abscess), peritonitis, or other severe systemic or life-threatening infections.

Generally, aztreonam should be continued for at least 48 hours after the patient becomes asymptomatic or evidence of bacterial eradication has been obtained. Persistent infections may require treatment for several weeks.

Following reconstitution, aztreonam for inhalation should be used at once using the Altera (R) Nebulizer System. It should not be used with any other nebulizer. Aztreonam for inhalation should not be mixed with any other drug in the Altera (R) Nebulizer Handset.

The use of a bronchodilator prior to administration of aztreonam for inhalation is recommended. Short-acting bronchodilators can be taken between 15 minutes and 4 hours prior to each dose and long-acting bronchodilators can be taken between 30 minutes and 12 hours prior to administration of aztreonam for inhalation.

What is the dose of Aztreonam for a child?

Usual Pediatric Dose for Intraabdominal Infection

7 days or less, 2000 g or less: 30 mg/kg IV every 12 hours

7 days or less, 2001 g or more: 30 mg/kg IV every 8 hours

8 to 30 days, 1199 g or less: 30 mg/kg IV every 12 hours

8 to 30 days, 1200 to 2000 g: 30 mg/kg IV every 8 hours

8 to 30 days, 2001 g or more: 30 mg/kg IV every 6 hours

1 month to 18 years: 30 mg/kg IV every 6 to 8 hours, up to a maximum of 2 g/dose or 8 g/day

Usual Pediatric Dose for Pneumonia

7 days or less, 2000 g or less: 30 mg/kg IV every 12 hours

7 days or less, 2001 g or more: 30 mg/kg IV every 8 hours

8 to 30 days, 1199 g or less: 30 mg/kg IV every 12 hours

8 to 30 days, 1200 to 2000 g: 30 mg/kg IV every 8 hours

8 to 30 days, 2001 g or more: 30 mg/kg IV every 6 hours

1 month to 18 years: 30 mg/kg IV every 6 to 8 hours, up to a maximum of 2 g/dose or 8 g/day

Usual Pediatric Dose for Bacterial Infection

7 days or less, 2000 g or less: 30 mg/kg IV every 12 hours

7 days or less, 2001 g or more: 30 mg/kg IV every 8 hours

8 to 30 days, 1199 g or less: 30 mg/kg IV every 12 hours

8 to 30 days, 1200 to 2000 g: 30 mg/kg IV every 8 hours

8 to 30 days, 2001 g or more: 30 mg/kg IV every 6 hours

1 month to 18 years: 30 mg/kg IV every 6 to 8 hours, up to a maximum of 2 g/dose or 8 g/day

Usual Pediatric Dose for Urinary Tract Infection

7 days or less, 2000 g or less: 30 mg/kg IV every 12 hours

7 days or less, 2001 g or more: 30 mg/kg IV every 8 hours

8 to 30 days, 1199 g or less: 30 mg/kg IV every 12 hours

8 to 30 days, 1200 to 2000 g: 30 mg/kg IV every 8 hours

8 to 30 days, 2001 g or more: 30 mg/kg IV every 6 hours

1 month to 18 years: 30 mg/kg IV every 6 to 8 hours, up to a maximum of 2 g/dose or 8 g/day

Usual Pediatric Dose for Skin and Structure Infection

7 days or less, 2000 g or less: 30 mg/kg IV every 12 hours

7 days or less, 2001 g or more: 30 mg/kg IV every 8 hours

8 to 30 days, 1199 g or less: 30 mg/kg IV every 12 hours

8 to 30 days, 1200 to 2000 g: 30 mg/kg IV every 8 hours

8 to 30 days, 2001 g or more: 30 mg/kg IV every 6 hours

1 month to 18 years: 30 mg/kg IV every 6 to 8 hours, up to a maximum of 2 g/dose or 8 g/day

Usual Pediatric Dose for Cystic Fibrosis

Inhalation:

7 years or older:

Initial dose: 75 mg via nebulizer over approximately 2 to 3 minutes 3 times a day for 28 days; doses should be at least 4 hours apart

Maintenance dose: Administer in alternating cycles of 28 days on and 28 days off.

For patients on multiple inhaled therapies, the following order of administration is recommended: bronchodilator, mucolytics, and lastly, aztreonam for inhalation.

How is Aztreonam available?

Aztreonam is available in the following dosage forms and strengths:

  • Intravenous solution,
  • Injectable powder for injection,
  • Inhalation powder for reconstitution.

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Aztreonam, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

 

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: August 29, 2018 | Last Modified: August 29, 2018

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