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Monobactam·Infectious Diseases - Other Antibiotics
Severe Gram-negative infections (UTI, intra-abdominal, respiratory) in patients with severe penicillin/cephalosporin anaphylaxis
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Max Dose
8 g/day
Half-life
2 h
Penicillin Allergy
SAFE
Caution: Gram Positive
NO COVER
Avoid / Cautions
Known specific anaphylaxis to Aztreonam itself. Ceftazidime allergy (shares an identical side chain with Ceftazidime; cross-reaction is possible!). Pregnancy Category B1.
Overview
The only monobactam antibiotic. Highly specific for aerobic Gram-negative bacteria (including Pseudomonas). Completely ignores Gram-positives and anaerobes.
Clinical Focus
Has zero cross-reactivity with penicillin or cephalosporin allergies. The ultimate safe 'big gun' for patients with severe IgE anaphylaxis to beta-lactams.
Bottom Line
Aztreonam is a monobactam with pure gram-negative coverage safe in penicillin allergy, but has no gram-positive or anaerobic activity requiring combination therapy for mixed infections.
Brand Names
Azactam
Parenteral
Vials (1 g powder) for IV infusion or deep IM.
Prescribing & PBS
Hospital supply. Restricted by Antimicrobial Stewardship.
Primary
Severe Gram-negative infections (UTI, intra-abdominal, respiratory) in patients with severe penicillin/cephalosporin anaphylaxis.
Clinical Place
Replaces Ceftriaxone or Tazocin in patients who will die of anaphylaxis if given a standard beta-lactam.
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