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It is a novel β-lactam antibiotic in which the other ring is missing (hence monobactam). It inhibits gram-negative enteric bacilli and H. influenzae at very low concentrations and Pseudomonas at moderate concentrations, but does not inhibit gram-positive cocci or faecal anaerobes. Thus, it is a P-lactam antibiotic with a spectrum resembling aminoglycosides. It is resistant to gram-negative β-lactamases. (1,2)

Bone and joint infections Gonorrhea Intra-abdominal infections Lower respiratory tract infections Meningitis Septicaemia Skin and soft tissue infections Pelvic infections Susceptible infections Cystitis Urinary tract infections (2)

Hypersensitivity Lactation (2)

IV: Phloebitis and thrombophloebitis. IM: Pain and swelling at inj site Diarrhea, nausea, vomiting, altered taste; jaundice, hepatitis, high liver enzymes; long prothrombin time, partial thromboplastin time; rash, urticaria, eosinophilia. Potentially Fatal: Thrombocytopenia, neutropenia; overgrowth of susceptible organisms; pseudomembranous colitis. (2)

Concurrent use with oral anticoagulants may increase prothrombin time. Concurrent use with nephrotoxic drugs may increase chances of renal failure. (2)

Dose adjustment is necessary in renal and liver failure patients Excreted in breast milk hence temporary discontinuation is advisable (1,2)

Dosage1,2: Adult For Urinary tract infections- 500 mg or 1 g for every 8 or 12hrs For Moderately severe systemic infection- 1 g or 2 g for every 8 or 12 hrs For Severe systemic or life-threatening infections- 2 g for every 6 or 8 hrs Maximum daily dose should not exceed 8gm/day For children Mild to moderate infections- 30 mg/kg for every 8 hrs Moderate to severe infections 30 mg/kg for every 6 or 8 hrs Maximum daily dose should not exceed 120mg/kg/day (1,2)

1. Katzung BG, Masters SB, Trevor AJ, editors. Basic & Clinical Pharmacology. 12th ed. New York: McGraw Hill; 2012 2. AZACTAM (aztreonam injection). [cited on 27th august 2013]. Available online from website.