KEY POINTS
- Aztreonam (Azactam) is a monobactam that binds to penicillin binding proteins (PBP) and interferes with cell wall synthesis for sensitive bacteria
- Has a high affinity for PBP-3
- Has an inhaled formulation (brand name Cayston)
- Has activity against Gram negative bacteria ONLY, like Pseudomonas aeruginosa
- Beware bacterial resistance to aztreonam
- Can be combined with avibactam to treat NDM-producing Gram negatives
- Since avibactam is not available alone, is combined with ceftazidime-avibactam for this purpose
- Has also been studied with vaborbactam, given with meropenem-vaboractacm
- Commonly reserved for use in patients with penicillin allergy
- Beware, aztreonam and ceftazidime cross-allergenicity
- Typical dose for IV formulation is 500 mg to 2 gm every 6 to 8 hours
- Dose-adjust for kidney dysfunction
RESOURCES
- Aztreonam Package Insert
- Evidence Of Aztreonam And Ceftazidime Cross-Allergenicity
- CDC Information on Penicillin Allergies
- IDSA Practice Guidelines
- Surgical Prophylaxis Guidelines
- Exploring Aztreonam in Combination with Ceftazidime-Avibactam or Meropenem-Vaborbactam as Potential Treatments for Metallo- and Serine-β-Lactamase-Producing Enterobacteriacea