Drug reference

Aztreonam

Monobactam (β-lactam) antibiotic · Antibacterial

START

1–2 g IV/IM every 8–12 h (severe Gram-negative)

TYPICAL MAX

8 g/day

STOP IF

Severe hypersensitivity, C. difficile colitis, or hepatotoxicity

WATCH

Renal function (dose-banding), LFTs, ceftazidime allergy history

CDSCO approvedATC J01DF01

Dose laddermg/d

Renal dose adjustmenteGFR mL/min/1.73m²

KDIGO 2024 + manufacturer label

Pharmacokineticsplasma · t hours

ONSET: 6min · infusion start
PEAK: 30min · end infusion
t½: 1.7h · t½
DURATION: 8h · q8h

EXCRETION

Renal — 60–70% unchanged

route + CYP

INTERACTIONS

—

none in our sources

PREGNANCY

Considered acceptable when indicated (β-lactam class).

FDA category + note

Mechanism

Binds penicillin-binding protein 3 of Gram-negative aerobes, inhibiting bacterial cell-wall synthesis; selective for aerobic Gram-negatives (including Pseudomonas) with no Gram-positive or anaerobic activity.

Indications

Complicated urinary tract infectionsLower respiratory tract infections (including cystic fibrosis Pseudomonas, inhaled form)SepticaemiaIntra-abdominal infections (combined with anaerobe coverage)Skin/soft-tissue infections (Gram-negative)Pelvic inflammatory disease

Dosing

Adult: 1–2 g IV/IM every 8–12 h (severe: 2 g q6–8h). Inhaled (CF): 75 mg nebulised three times daily for 28-day cycles.
Pediatric: ≥9 months: 30 mg/kg every 6–8 h; CF inhaled per protocol.
Renal adjustment: CrCl 10–30: reduce dose 50%. <10: reduce 75%; dose after HD.
Hepatic adjustment: Caution; reduce dose in severe disease.
Geriatric: Adjust for renal function.
Max dose: 8 g/day

Pharmacokinetics

Onset

Bactericidal levels from infusion

Peak effect

End of infusion

Duration

Dose every 6–12 h

Half-life

~1.7 h (~6 h in severe renal failure)

Bioavailability

IV/IM 100%; inhaled local

Protein binding

~56%

Metabolism

Minimal

Excretion

Renal (60–70% unchanged)

Contraindications

Severe hypersensitivity to aztreonam
Generally tolerated in penicillin allergy (no cross-reactivity except ceftazidime)
Caution: severe ceftazidime allergy (shared side chain)