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Aztreonam Side Effects

Medically reviewed by Last updated on May 14, 2023.


Commonly reported side effects of aztreonam include: fever. Continue reading for a comprehensive list of adverse effects.

Applies to aztreonam: inhalation powder for solution. Other dosage forms:

Serious side effects of Aztreonam

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

Other side effects of Aztreonam

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

Less common

  • Rash

For Healthcare Professionals

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


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


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[Ref]


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[Ref]

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


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

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[Ref]


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[Ref]

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


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%)[Ref]


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)[Ref]

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.[Ref]


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[Ref]

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.[Ref]


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[Ref]


Aztreonam for injection:

Uncommon (0.1% to 1%): Hypotension (less than 1%), transient electrocardiogram changes (ventricular bigeminy, premature ventricular contractions; less than 1%)[Ref]

Nervous system

Aztreonam for injection:

Uncommon (0.1% to 1%): Less than 1%: Seizure, headache, confusion, vertigo, paresthesia, insomnia, dizziness, tinnitus[Ref]


Aztreonam for inhalation:

Postmarketing reports: Arthralgia, joint swelling

Aztreonam for injection:

Uncommon (0.1% to 1%): Muscular aches (less than 1%)[Ref]


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

Aztreonam for injection:

Rare (less than 0.1%): Acute interstitial nephritis (at least 1 case)

Frequency not reported: Increased serum creatinine[Ref]


Aztreonam for injection:

Uncommon (0.1% to 1%): Less than 1%: Vaginal candidiasis, vaginitis, breast tenderness[Ref]


Aztreonam for injection:

Uncommon (0.1% to 1%): Diplopia (less than 1%)[Ref]


1. "Product Information. Azactam (aztreonam)." Bristol-Myers Squibb (2002):

2. "Aztreonam for inhalation solution (cayston) for cystic fibrosis." Med Lett Drugs Ther 52 (2010): 63-4

3. Newman TJ, Dreslinski GR, Tadros SS "Safety profile of aztreonam in clinical trials." Rev Infect Dis 7 (1985): s648-55

4. Daikos GK "Clinical experience with aztreonam in four Mediterranean countries." Rev Infect Dis 7 (1985): s831-5

5. Norrby SR "Clinical experience with aztreonam in Europe: a summary of studies in Belgium, England, Finland, Ireland, the Netherlands, Norway, Portugal, and Sweden." Rev Infect Dis 7 (1985): s836-9

6. Brogden RN, Heel RC "Aztreonam: a review of its antibacterial activity, pharmacokinetic properties and therapeutic use." Drugs 31 (1986): 96-130

7. "Aztreonam (azactam)." Med Lett Drugs Ther 29 (1987): 45-6

8. Chartrand SA "Safety and toxicity profile of aztreonam." Pediatr Infect Dis J 8 (1989): s120-3,128-32

9. Ramakrishnan K, Scheid DC "Diagnosis and management of acute pyelonephritis in adults." Am Fam Physician 71 (2005): 933-42

10. Guay DR, Koskoletos C "Aztreonam, a new monobactam antimicrobial." Clin Pharm 4 (1985): 516-26

11. Hopefl AW "Aztreonam: an overview." Drug Intell Clin Pharm 19 (1985): 165-9

12. Hara K, Kobayashi H, Nishiura T, Yura J, Saito A "Clinical studies of aztreonam in Japan." Rev Infect Dis 7 (1985): s810-24

13. Pasmino P "Acute renal failure, skin rash, and eosinophilia associated with aztreonam." Am J Nephrol 8 (1988): 68-70

14. Alvarez JS, del Castillo JA, Garcia IS, Ortiz MJ "Immediate hypersensitivity to aztreonam." Lancet 335 (1990): 1094

15. Clergeot A, Steru D, Rosset MA, Carbon C "Efficacy and safety of low-dose aztreonam in the treatment of moderate to severe infections due to gram-negative bacilli." Rev Infect Dis 13 (1991): s648-51

16. Sion ML, Pyrpasopoulos M, Nicolaidis P, Papagianni C, Tsurutsoglu G "Efficacy and safety of aztreonam in the treatment of patients with renal failure." Rev Infect Dis 13 (1991): s652-4

17. Hantson P, de Coninck B, Horn JL, Mahieu P "Immediate hypersensitivity to aztreonam and imipenem." Br Med J 302 (1991): 294-5

18. McDonald BJ, Singer JW, Bianco JA "Toxic epidermal necrolysis possibly linked to aztreonam in bone marrow transplant patients." Ann Pharmacother 26 (1992): 34-5

19. Prieto RD, Medina AA, Palla PS, Perez JMD, Merino MES, Garcia AF "Urticaria caused by sensitization to aztreonam." Allergy 48 (1993): 634-6

20. Pimiento AP, Martinez MG, Mena AM, Gonzalez AT, Arranz SD, Mosquera MR "Aztreonam and ceftazidime: evidence of in vivo cross-allergenicity." Allergy 53 (1998): 624-5

21. Stille W, Gillissen J "Clinical experience with aztreonam in Germany and Austria." Rev Infect Dis 7 (1985): s825-30

22. Dallal MM, Czachor JS "Aztreonam-induced myelosuppression during treatment of pseudomonas aeruginosa pneumonia." DICP 25 (1991): 594-7

Further information

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

Some side effects may not be reported. You may report them to the FDA.