aztreonam
Aztreonam (also known by its brand name, Azactam) is an antibiotic that treats a range of infections, including urinary tract infections (UTIs) and certain respiratory infections. Aztreonam (Azactam) belongs to the monobactam antibiotic class and can be given to people with a penicillin allergy. The dosage of aztreonam (Azactam) depends on how serious your infection is; it's typically give as an injection every 6 to 12 hours. Side effects aren't common, but can include injection site pain and swelling.
What is Aztreonam (Azactam)?
What is Aztreonam (Azactam) used for?
Lower respiratory tract infections (e.g., pneumonia, bronchitis)
Bloodstream infection
Skin infections (e.g., cellulitis)
How Aztreonam (Azactam) works
Aztreonam (Azactam) is a monobactam antibiotic that works by preventing bacteria from being able to make a cell wall around them. This causes the bacteria to die.
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What are the side effects of Aztreonam (Azactam)?
Common Side Effects
- Swelling or pain in the vein after IV injection (2%)
- Swelling or discomfort at the IM injection site (2%)
Other Side Effects
- Diarrhea
- Nausea
- Vomiting
- Rash
Serious Side Effects
- Serious allergic reaction: hives, rash, blisters, skin reddening, swelling of the lips or tongue, difficulty breathing
- Infectious diarrhea: foul-smelling diarrhea, frequent bowel movements (up to 15 times per day), fever, stomach pain or cramps
Source:Â DailyMed
The following side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Less common or rare
Black, tarry stools
blood in urine or stools
burning or itching of vagina
chills
confusion
convulsions (seizures)
dark urine
difficulty in breathing
discharge from vagina
discomfort, inflammation, or swelling at the injection site
dizziness
flu-like symptoms
general feeling of illness
headache
light gray-colored stools
loss of appetite
numbness of tongue
pinpoint red spots on skin
seeing double
skin rash, redness, or itching
unusual bleeding or bruising
unusual tiredness or weakness
yellow skin or eyes
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Less common or rare
Abdominal or stomach cramps
altered sense of taste
breast tenderness
burning or prickling feeling of skin
flushing
increased sweating
mouth ulcers
muscular aches
nausea or vomiting
ringing, buzzing, or noise in ear
small, nonraised, round, purplish or red spots on skin
trouble in sleeping
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Aztreonam (Azactam)
Pros
Low risk of side effects
Typically safe for people who are allergic to penicillin
Can be used in infants as young as 9 months old
Cons
Might need to be given as often as every 6 hours
Needs to be injected into the veins or into the muscle
It's not known is safe in pregnancy
Pharmacist tips for Aztreonam (Azactam)
Aztreonam (Azactam) can cause diarrhea. In general, it should go away when you're done with the treatment. But if you start having foul-smelling watery or bloody diarrhea, fever, tiredness, or stomach cramps anytime during treatment or after stopping aztreonam (Azactam), call your provider right away. These can be signs of a kind of infectious diarrhea that can be serious and needs to be treated right away.
If you're using aztreonam (Azactam) at home for long-term treatment, make sure to set a reminder of when your doses are due. It's important to get all of your doses of aztreonam (Azactam) and finish your treatment course, even if you feel better. Otherwise, your infection might get worse or become harder to treat.
Contact your provider if you develop other symptoms of an illness or if your symptoms become worse. They can check if aztreonam (Azactam) is still appropriate for you or whether you need more medical attention.
Frequently asked questions about Aztreonam (Azactam)
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What are the risks and warnings for Aztreonam (Azactam)?
Aztreonam (Azactam) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Allergic reactions
Risk factor: Allergy to beta-lactam antibiotics (e.g., penicillins, cephalosporins, carbapenems)
Aztreonam (Azactam) is typically safe to use for people with a severe penicillin allergy. But there's a very rare possibility that some people are allergic to aztreonam (Azactam). If so, they might experience reactions like facial swelling, shock, anaphylaxis (closing of the throat) and rarely, a severe and life-threatening skin reaction called toxic epidermal necrolysis (TEN). Let your provider know if you have an allergy to antibiotics. If you notice hives, rash, red skin, swelling of the lips or tongue, or difficulty breathing after treatment with aztreonam (Azactam), get medical attention right away.
Infectious diarrhea
Antibiotics, including aztreonam (Azactam), raise your risk of getting infected with a bacteria called Clostridioides difficile (C. diff). This infection can cause diarrhea that can sometimes be life-threatening. Antibiotics change the amount of normal bacteria in your stomach and intestines. This can cause C. diff to overgrow in your gut and lead to an infection. This type of infectious diarrhea is different than diarrhea as a possible side effect of aztreonam (Azactam). C. diff-related diarrhea can cause rapid heart rate, foul-smelling diarrhea, fever, nausea, frequent bowel movements (even up to 15 times per day), or bloody stools and is an emergency. If you experience any of these symptoms, get medical attention right away so you can be tested for C. diff infection and receive treatment.
Hard-to-treat infections
Your provider will monitor your treatment with aztreonam (Azactam) to make sure you're taking the antibiotic for the appropriate infection and amount of time. Using aztreonam (Azactam) for any shorter or longer periods of time or taking the antibiotic for other illnesses can raise your risk for developing infections caused by drug-resistant bacteria. This raises your risk for severe and life-threatening infections that might be difficult to treat.
Aztreonam (Azactam) dosage forms
Typical dosing for Aztreonam (Azactam)
The dose and length of treatment depends on what type of infection you have, how serious it is, and whether you have kidney problems. Your provider will determine the right dose and length of treatment for you.
Aztreonam (Azactam) is typically given as an injection into the veins (intravenous or IV) or into the buttock or thigh muscle (intramuscular or IM) by a provider in a healthcare setting (e.g., hospital, office, nursing home).
Adults
Urinary tract infections: The typical dose is 500 mg or 1,000 mg IV or IM every 8 or 12 hours.
Moderate-to-severe infections: The typical dose is 1 gram or 2 grams IV or IM every 8 or 12 hours.
Severe or life-threatening infections: The typical dose is 2 grams IV or IM every 6 or 8 hours.
Children
Your child's provider will determine their dose based on your child's body weight. The typical dose is 30 mg/kg given IV every 6 or 8 hours.
Interactions between Aztreonam (Azactam) and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Cholera Vaccine, Live
How much does Aztreonam (Azactam) cost?
What are alternatives to Aztreonam (Azactam)?
Lower respiratory tract infections (e.g., pneumonia, bronchitis)
Bloodstream infection
Skin infections (e.g., cellulitis)
Stomach infection in people ages 2 months and older
Pneumonia in people ages 2 months and older
Skin infection (e.g., cellulitis, foot infection due to diabetes) in adults
Pelvic infection in adult females
Pneumonia
Skin infections (e.g., cellulitis)
Stomach infections - add-on therapy to metronidazole (Flagyl)
Treatment of possible infections in people with febrile neutropenia
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References
Best studies we foundBush, L. M., et al. (2023). Overview of anaerobic bacteria. Merck Manual Professional Version.
Centers for Disease Control and Prevention. (2019). Pseudomonas aeruginosa in healthcare settings.
Cystic Fibrosis Foundation. (n.d.). Intro to CF.
E.R. Squibb * Sons, L.L.C. (2023). Azactam- aztronam injection, powder, for solution [package insert]. DailyMed.
James, C. W., et al. (2001). Cross-reactivity of beta-lactam antibiotics. Baylor University Medical Center Proceedings.
Lopez, N., et al. (2011). A comprehensive review of abdominal infections. World Journal of Emergency Surgery.
Pandey, N., et al. (2023). Beta-lactam antibiotics. StatPearls.
Pankey, G. A., et al. (2004). Clinical relevance of bacteriostatic versus bactericidal mechanisms of action in the treatment of gram-positive bacterial infections. Clinical Infectious Diseases.
Taylor, M., et al. (2023). Endometritis. StatPearls.
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