Aztreonam
General Information
Monobactam
In patients with a history of penicillin or cephalosporin allergy, aztreonam may be administered without prior testing unless there is a history of ceftazidime allergy where allergy testing would be required.
Restricted formulary antimicrobial: For details see OUH netFormulary
AWaRe antibiotic classification: 'Reserve'. All indications to be discussed with Micro/ID.
For all information regarding interactions, contraception, pregnancy and breastfeeding and additional information, see BNF and Summary of Product Characteristics (SPC).
Dosing
| Intravenous dose | |
| Standard dose | 1g TDS |
| Severe infections | 2g TDS - QDS |
Obesity
Consider using upper end of normal dosing in severe infections, taking renal function into account.
Renal and hepatic impairment
Renal impairment
|
eGFR (mL/min/1.73m2) |
Intravenous dose |
|
More than 30 |
Dose as in normal renal function |
|
10-30 |
1g-2g BD (50% of usual dose) |
|
Less than 10 |
1g-2g OD (25% of usual dose) |
|
HDF/High Flux |
Dialysed; give after dialysis Dose as in eGFR less than 10ml/min/1.73m2 |
|
PD |
Not dialysed Dose as in eGFR less than 10ml/min/1.73m2 NB - May be given via intra-peritoneal route. Discuss with Micro/ID |
In patients with renal impairment: There have been reports of encephalopathy with aztreonam (e.g. confusion, impairment of consciousness, epilepsy, movement disorders).
Hepatic impairment
- Use with caution. Monitor liver function and monitor for side effects including encephalopathy.
- A dose reduction of 20-25% is recommended for long-term treatment of patients with chronic liver disease with cirrhosis, especially in cases of alcoholic cirrhosis and when renal function is also impaired.
References
- Bristol Myers Squibb Pharmaceuticals limited. Azactam 1g Powder for Solution for Injection or Infusion-vial summary of product characteristics. Electronic Medicines Compendium. Last revision of the text 12/1/2023. Accessed via www.medicines.org.uk. Accessed 20/3/26
- The Renal Drug Database. Aztreonam. Last updated 5/12/25. Accessed via https://renaldrugdatabase.com Accessed 20/3/26
- British National Formulary. Aztreonam Accessed via: BNF online accessed via www.medicinescomplete.com Accessed 20/3/26
- Sanford Guide [online]. Aztreonam. Last updated 13/3/26. Accessed via https://webedition.sanfordguide.com. Accessed 20/3/26
- All-Wales Antimicrobial Pharmacists’ Group (2022) Antimicrobial dosing in extremes of body weight in adults. Accessed 20/3/26