Aztreonam

Gram Negative aerobic Bacterial Infections
1. Urinary Tract Infections
2. Intraabdominal and gynecologic infections
3. Pseudomonas aeruginosa infections
4. Cystic Fibrosis respiratory symptoms (nebulized Cayston)

Classified as a Monobactam
Monocyclic beta-lactam Antibiotic originally isolated from Chromobacterium violaceum
1. Binds to and inactivates Penicillin-binding Protein-3 (PBP-3)
2. Inhibits cross-linking of Bacterial cell wall components (similar to Carbapenems)
Activity against Gram Negative Bacteria (including Pseudomonas aeruginosa)
No significant Gram Positive activity
Wide tissue distribution (includes joints, CNS and urine)

Urinary Tract Infection
1. Give 0.5 to 1 gram IM or IV every 8 to 12 hours
Moderate Gram Negative Infections (e.g. intraabdominal, gynecologic)
1. Give 1 to 2 grams IM or IV every 8 to 12 hours
Severe Gram Negative Infections or Pseudomonas Infections
1. Give 2 grams IV every 6 to 8 hours
Cystic Fibrosis Respiratory Symptoms
1. Nebulize 1 Cayston vial (75 mg) three times daily for 28 days (then hold for at least 28 days)
2. Given only with Altera nebulizer, after both Bronchodilator and mucolytic
3. Administer after Bronchodilator - short acting (15 min to 4 h) or long-acting (30 min to 12 h)
Renal Dosing (eGFR <30 ml/min)
1. eGFR 10 to 30 ml/min: Give 1 to 2 g IV load, then give 50% of typical dose
2. eGFR <10: Give 0.5 to 2 g IV load, then give 25% of typical dose
3. Hemodialysis (life threatening infections)
  1. Give 12.5% of typical dose after each Hemodialysis run

Gram Negative Infections
1. Give 30 mg/kg IV every 6 to 8 hours
Cystic Fibrosis Respiratory Symptoms (age >= 7 years old)
1. Nebulize 1 Cayston vial (75 mg) three times daily for 28 days (then hold for at least 28 days)
2. Given only with Altera nebulizer, after both Bronchodilator and mucolytic
3. Administer after Bronchodilator - short acting (15 min to 4 h) or long-acting (30 min to 12 h)
Pseudomonas respiratory infection in Cystic Fibrosis (not FDA approved)
1. Give 50 mg/kg IV every 6 to 8 hours