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