Aztreonam

Background

• The only drug in the monobactam class of monocyclic ß-lactam antibiotic
• Originally isolated from Chromobacterium violaceum
• Spectrum includes gram-negative aerobic bacteria
  • Of special important, oftenn effective again ESBL-containing organisms, including metallo-ß-lactamases

Dosing

• UTI: 500 to 1000 mg IV every 8 to 12 hours
• Moderately severe infections: 1 to 2 g IV every 8 to 12 hours
• Severe or life-threatening infections: 2 g IV every 6 to 8 hours
  • Maximum daily dose is 8 g per day
• Pseudomonas aeruginosa: 2 g IV every 6 to 8 hours

Renal Dosing

• CrCl 10-30: 1 to 2 g IV load, followed by 50% of usual dose
• CrCl <10 and IHD: 500 mg to 2 g IV load, followed by 25% of usual dose
• IHD: in addition to above, also 12.5% of usual dose after each run of hemodialysis