Aztreonam

Aztreonam is a synthetic bactericidal antibiotic originally derived from Chromobacterium violaceum. It belongs to the monobactam class, which is structurally different from other beta-lactam antibiotics such as penicillins and cephalosporins. Aztreonam is primarily active against aerobic gram-negative bacteria.

• Urinary tract infections (cystitis, pyelonephritis)
• Lower respiratory tract infections (pneumonia)
• Intra-abdominal infections (peritonitis)
• Skin and soft tissue infections
• Gynecological infections (pelvic inflammatory disease)
• Septicemia
• Bone and joint infections
• Meningitis
• Pseudomonas aeruginosa infections in cystic fibrosis
• Infections in penicillin-allergic patients

Aztreonam inhibits bacterial cell wall peptidoglycan synthesis. It binds to penicillin-binding protein 3 (PBP-3), which plays a crucial role in cell division and wall formation in gram-negative bacteria. This leads to cell wall weakening and bacterial lysis.

Aztreonam binds with high affinity to penicillin-binding protein 3 (PBP-3) of gram-negative bacteria, inhibiting peptidoglycan synthesis, which results in cell wall weakening and bacterial death.

Adults: 1-2 g every 8-12 hours; severe infections: 2 g IV every 8 hours.

Pediatrics: 30-50 mg/kg every 8 hours, not to exceed adult dose. Neonates and infants: careful dose adjustment needed.

Renal dose: CrCl 10-30 mL/min: 1-2 g loading dose, then 50% of usual dose; CrCl <10 mL/min: 1-2 g loading dose, then 25% of usual dose.

Administered by healthcare professionals via intravenous (IV) infusion or intramuscular (IM) injection. IV infusion is typically given over 30 minutes. IM injections should be given deep into large muscles.

If you miss a dose, please consult your doctor.

• Rash
• Injection site reactions (pain, swelling, redness)
• Vomiting
• Nausea
• Diarrhea
• Cough
• Nasal congestion
• Wheezing
• Sore throat
• Pyrexia
• Chest discomfort
• Abdominal pain

Rare: Anaphylaxis, angioedema, bronchospasm, pancytopenia, neutropenia, thrombocytopenia

• Discontinue immediately if hypersensitivity reactions (anaphylaxis, angioedema) occur
• Prolonged use may lead to superinfection
• Caution in patients with allergy to penicillin or other beta-lactams
• Caution during pregnancy and lactation

• Known hypersensitivity to aztreonam or any component

• Concurrent use with oral anticoagulants may increase prothrombin time
• Avoid antibiotics that induce beta-lactamase production (cefoxitin, imipenem)
• Probenecid and furosemide increase aztreonam serum levels

Alcohol consumption does not cause any harmful effects.

[SAFE IF PRESCRIBED] Aztreonam is generally considered safe during pregnancy (Pregnancy Category B). Animal studies have not shown fetal risk. Use only if clearly needed.

[SAFE IF PRESCRIBED] Aztreonam is excreted in breast milk in small amounts (<1% of maternal serum concentration). Systemic effects in the infant are unlikely. Compatible with breastfeeding per AAP.

Safety and efficacy not established in infants <9 months. >9 months: 30 mg/kg every 6-8 hours. Cystic fibrosis: 50 mg/kg every 6-8 hours. >7 years: 75 mg thrice daily via nebulizer.

Elderly patients: use standard adult doses; monitor renal function closely.

[CAUTION] Dose adjustment needed in renal impairment.

[SAFE IF PRESCRIBED] No dose adjustment needed in hepatic impairment.

In case of overdose, provide symptomatic and supportive treatment.

Reconstituted solution is stable for 48 hours at 15-30°C and 7 days at 2-8°C. Store in original packages at 20-25°C.

Aztreonam (C₁₃H₁₇N₅O₈S₂)