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All about: Aztreonam

Big Image Pronouncation: (AZZ-TREE-oh-nam)
Class: Monobactam

Trade Names:
- Powder for injection (lyophilized cake) 500 mg (with approximately 780 mg L-arginine per gram aztreonam)
- Powder for injection (lyophilized cake) 1 g (with approximately 780 mg L-arginine per gram aztreonam)
- Powder for injection (lyophilized cake) 2 g (with approximately 780 mg L-arginine per gram aztreonam)
- Solution for injection 1 g per 50 mL
- Solution for injection 2 g per 50 mL

Mechanism of Action


Inhibits bacterial cell wall synthesis.




C max is 54 mcg/mL (500 mg dose), 90 mcg/mL (1 g dose); and 204 mcg/mL (2 g dose) immediately after administration.


T max is approximately 1 h; produces comparable serum concentrations to IV doses.


Vd is approximately 12.6 L; approximately 56% protein bound. Widely distributed to fluids and tissues, including CSF (inflamed meninges) and breast milk; crosses placenta.


The t ½ is approximately 1.7 h; serum clearance is 91 mL/min; renal clearance is 56 mL/min; 60% to 70% is recovered in the urine by 8 h; approximately 12% recovered in the feces.

Special Populations

Renal Function Impairment

Serum t ½ may be prolonged.

Hepatic Function Impairment

Serum t ½ may be prolonged.


Serum t ½ may be prolonged.

Indications and Usage

Treatment of infections of urinary tract, lower respiratory tract, skin and skin structure, intra-abdominal infections, gynecologic infections, surgical infections, and septicemia caused by susceptible microorganisms.

Unlabeled Uses

Treatment of acute, uncomplicated gonorrhea in patients with penicillin-resistant gonococci.


Standard considerations.

Dosage and Administration


IM/IV 500 mg or 1 g every 8 to 12 h.

Systemic Infections

IM/IV 1 to 2 g every 6 to 12 h.


IM/IV 30 to 50 mg/kg every 4 to 8 h.

Acute Uncomplicated Gonorrhea

IM 1 g. Max recommended dosage is 8 g/day.


Shake reconstituted solutions vigorously immediately after mixing. Reconstituted solutions not exceeding 2% are stable at room temperature for 48 h; stable under refrigeration for 7 days. Discard unused solutions. See the prescribing information for further storage and incompatibility information. Frozen infusion solutions may be stored for up to 3 mo at −4°F.

Drug Interactions

Beta-lactamase–inducing antibiotics (eg, cefoxitin, imipenem)

May antagonize activity of aztreonam and should not be used concurrently.


Nafcillin sodium, cephradine, and metronidazole are incompatible in admixture.

Laboratory Test Interactions


15% to 20% of patients had elevations of AST and ALT more than 3 times the ULN.

Adverse Reactions






Diarrhea; nausea; vomiting; pseudomembranous colitis.




Phlebitis/thrombophlebitis after IV administration; pain/swelling at IM injection site; fever.



Review culture and sensitivity of organism as available.


Category B .


Excreted in breast milk.


Safety and efficacy in children younger than 9 mo of age not established.


Reactions range from mild to life-threatening. Administer cautiously to penicillin- or cephalosporin-sensitive patients because of possible cross-reactivity.

Renal Function

Reduced dose required.


May result in overgrowth of nonsusceptible bacterial or fungal organisms.

Patient Information

  • Encourage patient to increase fluid intake to 2,000 to 3,000 mL/day, if allowed.
  • Inform patient to notify health care provider if rash or difficulty breathing is experienced.
  • If therapy is discontinued because of allergic reaction, explain significance of penicillin allergy and of potential problems with cephalosporins.
  • Caution patient against skipping doses or stopping treatment early, which could result in recurrence of symptoms and potential resistance of the organism to this product.

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