Aztreonam
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| ID | DRUG-AZTREONAM |
|---|---|
| Тип | Препарат |
| Синоніми | AzactamCaystonАзтреонам |
| Статус | переглянуто 2026-04-27 | очікує клінічного підпису |
| Хвороби | Не вказано |
| Джерела | SRC-NCCN-BCELL-2025 SRC-NCCN-MM-2025 |
Дані про препарат
| Клас | Monobactam β-lactam antibiotic (Gram-negative only; aerobic coverage including Pseudomonas) |
|---|---|
| Механізм дії | Synthetic monocyclic β-lactam antibiotic that binds penicillin- binding protein 3 (PBP-3) of aerobic Gram-negative bacilli with high affinity, inhibiting cell-wall synthesis and producing bactericidal effect. Activity narrowly restricted to aerobic Gram-negative bacteria including Pseudomonas aeruginosa, Enterobacterales (most), Haemophilus, Neisseria. NO activity against Gram-positive bacteria, anaerobes, atypicals. Unique monobactam structure does NOT cross-react with penicillin or cephalosporin antibodies in IgE-mediated hypersensitivity, making aztreonam the preferred Gram-negative β-lactam for patients with documented severe penicillin allergy (including anaphylaxis). The exception is ceftazidime, which shares the aminothiazolyl side chain — patients with confirmed ceftazidime hypersensitivity may also react to aztreonam. FDA-approved 1986. |
| Типове дозування | Severe Gram-negative infection / FN (adult): 2 g IV every 6-8 hours via 30-min infusion. Pediatric: 30 mg/kg IV q6-8h, max 2 g per dose; cystic fibrosis chronic suppression 50 mg/kg q6h. Renal adjustment required: CrCl 10-30 → 50% dose reduction (e.g., 1 g q6-8h); CrCl <10 → 25% of usual dose (e.g., 500 mg q6-8h); hemodialysis → 500 mg q6-8h with extra 12.5% of initial dose after each dialysis session; CRRT → 1 g q8h. Hepatic: no adjustment. Duration in FN combination: per source / syndrome, typically 7-14 days. CRITICAL pairing in penicillin-allergic FN: aztreonam (Gram-negative) + vancomycin (Gram- positive) ± metronidazole (anaerobic) covers approximately the same spectrum as pip-tazo mo... |
| Зареєстровано в Україні | True |
| Відшкодовується НСЗУ | True |
| Остання перевірка для України | 2026-04-27 |
Нотатки
Niche but essential agent for documented severe penicillin allergy (anaphylaxis, SJS, DRESS) in patients requiring Gram-negative coverage — particularly in febrile neutropenia where the standard pip-tazo / cefepime / meropenem options are excluded. Standard FN regimen for severe penicillin allergy: aztreonam 2 g IV q8h + vancomycin (MRSA + Gram-positive coverage) + metronidazole 500 mg IV q8h (anaerobic coverage if intra-abdominal source). Note the ceftazidime cross-reactivity caveat (shared aminothiazolyl side chain) — confirm allergy history specifically asks about ceftazidime. For most labeled "penicillin allergy" patients without severe immediate-type reactions, modern allergy de-labeling protocols with skin testing or graded challenge can restore access to standard β-lactams; allergy consultation often warranted before defaulting to aztreonam-based regimens. Ukraine: registered, NSZU-covered for documented severe β-lactam allergy.
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