Aztreonam Side Effects

Not all side effects for aztreonam may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

For the Consumer

Applies to aztreonam: inhalation powder for solution

Along with its needed effects, aztreonam may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking aztreonam:

More common
  • Chest discomfort
  • cough
  • difficulty with breathing or troubled breathing
  • fever
Less common
  • Noisy breathing
  • shortness of breath
  • tightness in the chest

Some side effects of aztreonam may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
  • Abdominal or stomach pain
  • sore throat
  • stuffy nose
  • vomiting
Less common
  • Rash

For Healthcare Professionals

Applies to aztreonam: inhalation powder for reconstitution, injectable powder for injection, intravenous solution

General

Aztreonam for injection was generally well tolerated. The overall incidence of systemic side effects was about 1% to 1.3%.

Respiratory

Aztreonam for inhalation:
Very common (10% or more): Cough (54%), nasal congestion (16%), wheezing (16%)
Common (1% to 10%): Bronchospasm (3%)
Postmarketing reports: Dyspnea

Aztreonam for injection:
Uncommon (0.1% to 1%): Less than 1%: Wheezing, dyspnea, chest pain, sneezing, nasal congestion

Other

Superinfection has been reported in up to 10% of patients during aztreonam therapy and was usually due to enterococcus or staphylococcus.

Aztreonam for inhalation:
Very common (10% or more): Pyrexia (13%), pharyngolaryngeal pain (12%)
Common (1% to 10%): Chest discomfort (8%), abdominal pain (7%)

Aztreonam for injection:
Common (1% to 10%): Superinfection (up to 10%)
Uncommon (0.1% to 1%): Less than 1%: Weakness, fever, malaise, flushing

Gastrointestinal

Onset of pseudomembranous colitis symptoms may occur during or after antibiotic treatment.

Aztreonam for inhalation:
Common (1% to 10%): Vomiting (6%)

Aztreonam for injection:
Common (1% to 10%): 1% to 1.3%: Nausea, vomiting, diarrhea
Uncommon (0.1% to 1%): Less than 1%: Abdominal cramps, mouth ulcer, altered taste, numb tongue, halitosis
Rare (less than 0.1%): Clostridium difficile associated diarrhea, pseudomembranous colitis, gastrointestinal bleeding

Dermatologic

Aztreonam for inhalation:
Common (1% to 10%): Rash (2%)

Aztreonam for injection:
Common (1% to 10%): Rash (1% to 1.3%)
Uncommon (0.1% to 1%): Less than 1%: Toxic epidermal necrolysis, purpura, erythema multiforme, exfoliative dermatitis, urticaria, petechiae, pruritus, diaphoresis

Toxic epidermal necrolysis associated with aztreonam has been reported in very ill patients on many other medications, making implication of aztreonam difficult.

Local

Aztreonam for injection:
Common (1% to 10%): Discomfort/swelling at the injection site after intramuscular administration (2.4%), phlebitis/thrombophlebitis after intravenous administration (1.9%)

Hypersensitivity

Aztreonam for inhalation:
Frequency not reported: Allergic reaction (with facial rash, facial swelling, throat tightness)

Aztreonam for injection:
Uncommon (0.1% to 1%): Less than 1%: Anaphylaxis, angioedema, bronchospasm
Rare (less than 0.1%): Maculopapular eruption (at least 1 case)

A 57-year-old male developed a widespread maculopapular eruption two hours after receiving aztreonam. Corticosteroids and antihistamines were needed to control the reaction which disappeared after 8 days. The patient also showed cross-reactivity to ceftazidime which shares the same side chain as aztreonam.

Hematologic

A case of myelosuppression associated with aztreonam has been reported, but because many other drugs were administered and because the patient was bacteremic, implication of aztreonam as the causative agent was difficult.

In vitro studies have shown that aztreonam may inhibit ADP-induced platelet aggregation at high concentrations. Clinically, therapeutic doses of aztreonam have not been associated with bleeding problems.

Aztreonam for injection:
Uncommon (0.1% to 1%): Less than 1%: Pancytopenia, neutropenia, thrombocytopenia, anemia, eosinophilia, leukocytosis, thrombocytosis
Frequency not reported: Increased prothrombin time, increased partial thromboplastin time, positive Coombs' test

Hepatic

Aztreonam for injection:
Uncommon (0.1% to 1%): Less than 1%: Hepatitis, jaundice, signs or symptoms of hepatobiliary dysfunction
Frequency not reported: Elevated AST, elevated ALT, elevated alkaline phosphatase

Cardiovascular

Aztreonam for injection:
Uncommon (0.1% to 1%): Hypotension (less than 1%), transient electrocardiogram changes (ventricular bigeminy, premature ventricular contractions; less than 1%)

Nervous system

Aztreonam for injection:
Uncommon (0.1% to 1%): Less than 1%: Seizure, headache, confusion, vertigo, paresthesia, insomnia, dizziness, tinnitus

Musculoskeletal

Aztreonam for inhalation:
Postmarketing reports: Arthralgia, joint swelling

Aztreonam for injection:
Uncommon (0.1% to 1%): Muscular aches (less than 1%)

Renal

Aztreonam for injection:
Rare (less than 0.1%): Acute interstitial nephritis (at least 1 case)
Frequency not reported: Increased serum creatinine

Acute interstitial nephritis associated with aztreonam has been reported in a very ill patient receiving many other medications.

Genitourinary

Aztreonam for injection:
Uncommon (0.1% to 1%): Less than 1%: Vaginal candidiasis, vaginitis, breast tenderness

Ocular

Aztreonam for injection:
Uncommon (0.1% to 1%): Diplopia (less than 1%)

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