Uses of Reonam: - Severe bacterial infections Bone and joint infections, Intra-abdominal infections, Lower respiratory tract infections, Meningitis, Septicaemia, Skin and soft tissue infections, Pelvic infections, Gonorrhoea, Cystitis, Urinary tract infections, Cystic fibrosis Hypersensitivity to aztreonam.

Other beta-lactam Antibiotics

Aztreonam is a synthetic bactericidal monobactam antibiotic. It inhibits bacterial cell wall synthesis by blocking peptidoglycan crosslinking. The inhibition of bacterial cell wall synthesis occurs due to a high affinity of Aztreonam for penicillin binding protein 3 (PBP3). By binding to PBP3, Aztreonam inhibits the third and last stage of bacterial cell wall synthesis. Cell lysis is then mediated by bacterial cell wall autolytic enzymes such as autolysins. It is possible that Aztreonam interferes with an autolysin inhibitor.

How to use Aztreonam: Your doctor or nurse will give you this medicine. Kindly do not self administer. Administration: Reconstitution: IM: Reconstitute vial w/ at least 3 mL of sterile water for inj, sterile bacteriostatic water for inj, normal saline, or bacteriostatic NaCl per g of aztreonam; immediately shake vigorously. IV: Bolus inj: Reconstitute vial w/ 6-10 mL of sterile water for inj. Infusion: Reconstitute vial w/ at least 3 mL of sterile water for inj per g of aztreonam; immediately shake vigorously. Then further dilute in an appropriate soln for infusion to a final concentration of <2%. Adult Dose: Adult: IV/IM Gm-ve infections 1-8 g/day in divided doses depending on severity. Max: 8 g/day. UTI 0.5-1 g 8-12 hrly. IM Cystitis; Gonorrhoea 1 g as a single dose. Child Dose: Child: IV, IM 90–120 mg/kg/day q6–8hr Infants >1 wk: 30 mg/kg every 6 or 8 hr Renal Dose: Renal impairment CrCl 10-30 mL/min: 1-2 g loading dose, then 50% of usual dosage CrCl <10 mL/min: 1-2 g loading dose, then 25% of usual dosage

Concurrent use w/ oral anticoagulants may increase prothrombin time.

Hypersensitivity to aztreonam.

Common - Rash - Injection site reactions (pain, swelling, redness) - Vomiting - Nausea - Diarrhea >10% Injection Pain at injection site (12%; children); (2%; adults) Increase in serum transaminases (4-6%) Neutropenia (3-11%, children); (<1%, adults) 1-10% Rash (4%),Thrombocytopenia (4%, children); (<1% adults),Diarrhea (1%),Nausea (1%),Vomiting (1%),Fever (<1%) < 1% Abnormal taste,Anaphylaxis,Anemia,Angioedema,Aphthous ulcer,Breast tenderness,Bronchospasm,Clostridium difficile-associated diarrhea (CDAD),Confusion,Diplopia,Dizziness,Dsypnea,Electrocardiographic changes (transient),Erythema multiforme,Eosinophilia,Fever,Flushing,Halitosis,Headache,Hepatitis,Hypotension,Insomnia,Jaundice,Leukocytosis,Neutropenia,Pancytopenia,Seizures,Thrombocytopenia,Tinnitus,Tongue numbness,Toxic epidermal necrolysis,Urticaria,Vaginitis,Vertigo,Weakness,Wheezing Potentially Fatal: Clostridium difficile-associated diarrhoea from mild diarrhoea to fatal colitis.

Pregnancy Category B. Aztreonam crosses the placenta and enters the fetal circulation. So it should be used during pregnancy only if the potential benefit justifies the potential risk.Aztreonam is excreted in breast milk in concentrations that are less than 1% of concentrations determined in simultaneously obtained maternal serum. Temporary discontinuation of nursing is recommended.

Precaution: History of β-lactam hypersensitivity. Renal and hepatic impairment. Childn. Pregnancy and lactation. Monitoring Parameters Monitor for signs of anaphylaxis during 1st dose; periodic LFT. Consider measuring FEV1 prior to initiation of inhalation therapy. Lactation: Drug is excreted in milk in low concentrations; use not recommended (American Academy of Pediatrics committee states that drug is compatible with nursing)

If necessary, Aztreonam may be cleared from the serum by hemodialysis and/or peritoneal dialysis.

Store in a cool & dry place, protected from light & moisture. Keep all medicines out of reach of children.

Other beta-lactam Antibiotics

Aztreonam inhibits bacterial cell wall synthesis due to its high affinity for penicillin-binding protein 3 (PBP-3) of gm-ve bacteria. It is highly resistant to hydrolysis by many narrow-spectrum β-lactamases. It is also active against most Enterobacteriaceae (including E. coli, Citrobacter, Enterobacter, Klebsiella, Proteus, Providencia, Salmonella, Serratia, Shigella, Yersinia spp. and Morganella morganii).

Pregnancy category: B Lactation: Drug is excreted in milk in low concentrations; use not recommended (American Academy of Pediatrics committee states that drug is compatible with nursing)