Aztreonam

CLINICAL USE

Antibacterial agent

DOSE IN NORMAL RENAL FUNCTION

  • 1 g every 8 hours or 2 g every 12 hours
  • Severe infections: 2 g every 6–8 hours
  • UTI: 0.5–1 g every 8–12 hours

    PHARMACOKINETICS

  • Molecular weight                           :435.4
  • %Protein binding                           :60
  • %Excreted unchanged in urine     : 60–70
  • Volume of distribution (L/kg)       :0.5–1
  • half-life – normal/ESRD (hrs)      :1.7/6–8

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

    30–50 Dose as in normal renal function10–30 1–2 g loading dose, then maintenance of 50% of appropriate normal dose

  • <10           : 1–2 g loading dose, then maintenance of 25% of appropriate normal dose

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD                :Not dialysed. Dose as in GFR <10 mL/min
  • HD                     :Dialysed. Dose as in GFR
  • <10           : mL/min
  • HDF/high flux   :Dialysed. Dose as in GFR
  • <10           : mL/min
  • CAV/VVHD      :Dialysed. Loading dose of 2 g then 1–2 g every 12 hours1,2 CVVhd/HDFDialysed. 2 g every 12 hours2

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugsPossibly enhanced anticoagulant effect of coumarins

    ADMINISTRATION

    Reconstition

    3 mL of water for injection per 1 g vial

    Route

    IM, IV bolus,

    IV infusion

    Rate of Administration

    IM injection: Give by deep injection into a large muscle massIV: Slowly inject directly into the vein over a period of 3–5 minutes

    IV infusion

    : Give over 20–60 minutes

    Comments

    Suitable infusion solutions: glucose 5%, sodium chloride 0.9%, compound sodium lactateDilute to a concentration of not less than 20 mg/mLOnce reconstituted aztreonam can be stored in a refrigerator for 24 hoursIV route recommended for single doses >1 g

    OTHER INFORMATION

    Manufacturers recommend that patients with renal impairment be given the usual initial dose followed by a maintenance dose adjusted according to creatinine clearance.

  • The normal dose interval should not be altered
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