Attemz

Aerobic gm -ve infections eg, UTI including pyelonephritis & cystitis (initial & recurrent) & asymptomatic bacteriuria, including those due to pathogens resistant to aminoglycosides, cephalosporins or penicillins. Acute uncomplicated urogenital or anorectal infections due to β-lactamase producing or non-producing strains of N. gonorrhoeae. Lower resp tract infections including pneumonia, bronchitis & lung infections in patients w/ cystic fibrosis. Bacteraemia/septicaemia; meningitis caused by H. influenzae or Neisseria meningitidis. Bone & joint; skin & soft tissue; intra-abdominal; gynaecological infections. Adjunct therapy to surgery in the management of infections caused by susceptible organisms, including abscesses, cutaneous infections, infections complicating hollow viscus & of serous surfaces.

IM or IV inj Administer by deep inj into a large muscle mass eg, upper quadrant of the gluteus maximus or lateral part of the thigh. Adult 1-8 g daily in equally divided doses. Usual dose: 3-4 g daily. Max recommended dose: 8 g daily. IV route is recommended for patients requiring single doses >1 g, or those w/ bacterial septicaemia, localised parenchymal abscess (eg, intra-abdominal abscess), peritonitis, meningitis or other severe systemic or life-threatening infections UTI 500 mg or 1 g IM/IV every 8 or 12 hr. Gonorrhoea/cystitis 1 g IM as single dose. Cystic fibrosis 2 g IV every 6-8 hr. Moderately severe systemic infections 1 or 2 g IM/IV every 8 or 12 hr. Severe systemic or life-threatening infections 2 g IM/IV every 6 or 8 hr. Other infections 1 g IM or IV every 8 hr or 2 g IV every 12 hr. IV infusion Combination therapy Ceftazidime-avibactam 2.5 g every 8 hr infused over 3 hr + aztreonam 2 g every 8 hr infused over 3 hr. Paed >1 wk old 30 mg/kg/dose every 6 or 8 hr, ≥2 yr 50 mg/kg/dose every 6 or 8 hr for severe infections. Infections due to P. aeruginosa 50 mg/kg every 6-8 hr. Max daily paed dose: Not >8 g daily. Patients w/CrCl between 10-30 mL/min/1.73 m² Dosage should be halved after an initial usual dose. Patients w/ severe renal failure (CrCl <10 mL/min/1.73 m²) & those supported by hemodialysis Usual initial dose. Maintenance dose: ¹/₄ of the usual initial dose given at the usual fixed interval of 6, 8 or 12 hr. For serious or life-threatening infections, ¹/₈ of the initial dose should be given in addition to the maintenance doses after each hemodialysis session. Patients w/ chronic liver disease w/cirrhosis, alcoholic cirrhosis & w/ impaired renal function Dose reduction of 20-25% for long-term treatment.

Hypersensitivity. Pregnancy.

History of allergic reaction; serious hypersensitivity reactions may require epinephrine & other emergency measures. Discontinue use if an allergic reaction occurs; Clostridium difficile-associated diarrhoea is suspected or confirmed; consider careful medical history since it has been reported to occur over 2 mth after the administration of antibacterial. Stop treatment in case of serious hemogram & skin changes. Serious blood & skin disorders, including pancytopenia & TEN. Overgrowth of non-susceptible organisms, including gm +ve organisms & fungi. Prolongation of prothrombin time/increased activity of oral anticoagulants; monitor & adjust oral anticoagulant doses w/ concomitant use. Potential nephrotoxicity & ototoxicity w/ concomitant use of aminoglycosides; monitor renal function during therapy. Interference w/ serological testing; +ve direct or indirect Coombs test. Concurrent therapy w/ other antimicrobials is recommended as initial therapy in patients at risk of having an infection due to pathogens that are not susceptible to aztreonam. May impair ability to drive & use machines if encephalopathy occur. Impaired hepatic or renal function. Pregnancy. Lactating mothers should refrain from breastfeeding during therapy. Newborns <1 wk; carefully assess use & consider arginine exposure in low birth wt infants owing to potential increases in serum arginine, insulin, & indirect bilirubin. Paed. Elderly w/ CrCl <30 mL/min.

TEN.

Antagonistic effect w/ β-lactamase antibiotics (eg, cefoxitin, imipenem) for certain gm -ve aerobes eg, Enterobacter sp & Pseudomonas sp. Concomitant use w/ anticoagulants.

Other Beta-Lactams

J01DF01 - aztreonam ; Belongs to the class of monobactams. Used in the systemic treatment of infections.

S