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Aztreonam/Azactam


- for aerobic Gm Neg bact and Enteric & P. aeruginosa
- Adult: 1-2gm IV/IM q6-12hr;
- Not effective for Gm pos nor anaerobic bacteria;
- Poor activity with: Staph, enterococci, NonEnteroStrep;
- may be given to Penicillin sensative individuals;
- Good diffusion from blood into CSF only with inflammation;
    Ratio of CSF to Blood Level (%): Normal Meninges: 1;
    Inflammed Meninges: 8-40;
- Dosing Regimens for Patients w/ Renal Insufficiency: (Dose for 70kg Adult
    {gm/dosinginterval inhours}): CrCl:>80: 1-2/6; CrCl:50-79: 1-2/6;
     CrCl:30-49: 1-2/6; CrCl:10-29: 0.5-1/6;;
 - Note: this is a relatively safe drug, even in patients with impaired renal function; Consequently because of the minimal risk of nephrotoxicity with aztreonam, may clinicians advocate its use over that of an aminoglycoside for the treatment of gram negative infections in patients with renal insufficiency;
 - Aztreonam is primary eliminated by the kidneys via tubular secretion and GFR;
 - in patients with end stage renal disease the drug may be administered once daily;
 - it is significantly removed by hemodialysis, therefore maintenence doses should be administered after dialysis on dialysis days;
- Note: visual disturbances; Paresthesia: Convulsions