Aztreonam with avibactam
General Information
Monobactam and beta-lactamase inhibitor antibiotic
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: All indications to be discussed with Micro/ID. Has not been classified in 2025 UK modified AWaRe list.
Note: There is an EPR powerplan associated with this drug.
For all information regarding contra-indications, interactions, contraception, pregnancy and breastfeeding and additional information, see BNF and Summary of Product Characteristics (SPC).
Standard dose
| Intravenous dose | |
| Standard dose |
Loading dose: 2.7g (2g aztreonam / 677mg avibactam) single dose followed 6 hours later by Maintenance dose: 2g (1.5g aztreonam / 500mg avibactam) QDS |
- Each vial contains 1.5g aztreonam + 0.5g avibactam
- Standard maintenance dose of 2g (1.5g aztreonam + 0.5g avibactam) is 1 vial
Obesity
No dose adjustment required.
Renal and hepatic impairment
Renal impairment
| Creatinine Clearance (mL/min)* | Dose |
| 51 and above |
Dose as in normal renal function |
| 30 - 50 |
Loading dose: 2.7g (2g aztreonam / 677mg avibactam) single dose followed 6 hours later by Maintenance dose: 1g (750mg aztreonam / 250mg avibactam) QDS |
| 16 - 29 |
Loading dose: 1.8g (1.35g aztreonam / 450mg avibactam) single dose followed 8 hours later by Maintenance dose: 900mg (675mg aztreonam / 225mg avibactam) TDS |
|
15 or less AND on HD/HDF/High flux or PD** |
Loading dose: 1.3g (1g aztreonam / 333mg avibactam) single dose followed 12 hours later by Maintenance dose: 900mg (675mg aztreonam / 225mg avibactam) BD |
*dose ranges use creatinine clearance, rather than eGFR
**Aztreonam-avibactam should not be used in patients with CrCL 15 mL/min or less unless haemodialysis or another form of renal replacement therapy is initiated.
Hepatic impairment
No dose adjustment required.
References
- Pfizer Limited. Summary of Product Characteristics (SPC). Emblaveo 1.5 g/0.5 g powder for concentrate for solution for infusion. Last revision of the text: 03/2025. Accessed via www.medicines.org.uk Accessed 08/09/2025
- BNF online accessed via www.medicinescomplete.com Accessed 08/09/2025
- The Renal Drug Database. EMBLAVEO (aztreonam/avibactam sodium). [online]. Last updated: 27/05/2025. Accessed via https://renaldrugdatabase.com Accessed 08/09/2025