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

See how to identify renal failure stages according to GFR calculation

See how to diagnose irreversible renal disease

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