Avibactam / Aztreonam Dosage

Medically reviewed by Drugs.com. Last updated on Jun 30, 2025.

Usual Adult Dose for Intraabdominal Infection

Loading dose: 2.67 g IV once
Maintenance dose: 2 g IV every 6 hours
Duration of therapy: 5 to 14 days

Comments:

• Approval of this indication is based on limited clinical safety and efficacy data for this combination drug.
• Administer by IV infusion over 3 hours.
• This drug should be administered concurrently with metronidazole.

Use: In combination with metronidazole, in patients with limited or no alternative options, for the treatment of complicated intraabdominal infections (cIAI), including those caused by susceptible Escherichia coli, Klebsiella pneumoniae, K oxytoca, Enterobacter cloacae complex, Citrobacter freundii complex, and Serratia marcescens

Renal Dose Adjustments

Estimated CrCl greater than 50 mL/min: No adjustment recommended

Estimated CrCl greater than 30 and up to 50 mL/min:

• Loading dose: 2.67 g IV once
• Maintenance dose: 1 g IV every 6 hours

Estimated CrCl greater than 15 and up to 30 mL/min:

• Loading dose: 1.8 g IV once
• Maintenance dose: 0.9 g IV every 8 hours

Estimated CrCl up to 15 mL/min:

• Loading dose: 1.33 g IV once
• Maintenance dose: 0.9 g IV every 12 hours

Total Duration of Therapy: 5 to 14 days

Comments:

• Estimated CrCl is calculated using the Cockcroft-Gault formula.
• Close monitoring of estimated CrCl is recommended; CrCl estimated from serum creatinine can change quickly in some patients, especially early in the treatment of the infection.

Liver Dose Adjustments

Liver dysfunction: No adjustment recommended

Comments:

• This drug has not been studied in patients with liver dysfunction, but neither component appears to undergo significant liver metabolism.

Precautions

CONTRAINDICATIONS:

• Known hypersensitivity to either active component or to any of the ingredients

Safety and efficacy have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.

Dialysis

Hemodialysis:

• Loading dose: 1.33 g IV once
• Maintenance dose: 0.9 g IV every 12 hours

Comments:

• Both components are hemodialyzable; this drug should be administered after hemodialysis on hemodialysis days.
• Close monitoring of estimated CrCl is recommended; CrCl estimated from serum creatinine can change quickly in some patients, especially early in the treatment of the infection.

Other Comments

2.67 g avibactam-aztreonam contains 2 g aztreonam and 0.67 g avibactam
2 g avibactam-aztreonam contains 1.5 g aztreonam and 0.5 g avibactam
1.8 g avibactam-aztreonam contains 1.35 g aztreonam and 0.45 g avibactam
1.33 g avibactam-aztreonam contains 1 g aztreonam and 0.33 g avibactam
1 g avibactam-aztreonam contains 0.75 g aztreonam and 0.25 g avibactam
0.9 g avibactam-aztreonam contains 0.675 g aztreonam and 0.225 g avibactam

Administration advice:

• Administer all doses by IV infusion over 3 hours.
• A single loading dose is followed by maintenance doses starting at the next dosing interval.
• Dosing interval is calculated from the start of 1 infusion to the start of the subsequent infusion.

Storage requirements:

• Vials (lyophilized powder): Store in carton until time of use at 2C to 8C (36F to 46F); protect from light.
• Reconstituted solution: May store for up to 60 minutes at 30C (86F) under ambient light before transfer and dilution in a suitable infusion bag
• Diluted reconstituted solution:
• If diluted with 0.9% Sodium Chloride Injection or Lactated Ringer's Injection: Refrigerate at 2C to 8C (36F to 46F) for up to 24 hours followed by 12 hours at not more than 30C (86F) under ambient light.
• If diluted with 5% Dextrose Injection: Refrigerate at 2C to 8C (36F to 46F) for up to 24 hours followed by 4 hours at not more than 30C (86F) under ambient light.
• Discard unused portion.

Reconstitution/preparation techniques:

• The powder must be reconstituted and then diluted before IV infusion.
• The manufacturer product information should be consulted.

IV compatibility:

• Compatible: Sterile Water for Injection, 0.9% Sodium Chloride Injection, 5% Dextrose Injection, Lactated Ringer's Injection
• The compatibility of this drug with other medicinal products has not been established; this drug should not be mixed with or physically added to solutions containing other medicinal products.

General:

• Aztreonam-avibactam is a combination product in a fixed 3:1 ratio; each vial contains aztreonam 1.5 g and avibactam 0.5 g.
• To reduce the development of drug-resistant organisms and maintain effective therapy, this drug should be used only to treat infections proven or strongly suspected to be caused by susceptible bacteria.
• Culture and susceptibility information should be considered when selecting/modifying antibacterial therapy or, if no data are available, local epidemiology and susceptibility patterns may be considered when selecting empiric therapy.

Monitoring:

• Hepatic: Liver-related laboratory tests (during therapy)
• Renal: Estimated CrCl in patients with renal dysfunction (during therapy)

Patient advice:

• Avoid missing doses and complete the entire course of therapy.
• Consult health care provider if severe watery or bloody diarrhea develops.

See also:

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer