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Emblaveo
aztreonam/ avibactam
Adult Dosing .
Dosage forms: INJ
Special Note
- [strength clarification]
- Info: doses expressed as total aztreonam + avibactam amount; 2 g aztreonam/avibactam contains 1.5 g aztreonam + 0.5 g avibactam
intra-abdominal infections, complicated
- [2 g IV q6h x5-14 days]
- Start: 2.67 g IV x1; Info: give with metronidazole; not 1st-line agent
renal dosing
- [see below]
- CrCl 31-50: 1 g q6h, start 2.67 g x1; CrCl 16-30: 0.9 g q8h, start 1.8 g x1; CrCl <16: 0.9 g q12h, start 1.33 g x1
- HD: 0.9 g q12h, start 1.33 g x1, on dialysis days administer after dialysis; consider supplement if next maintenance dose not due right after dialysis; PD: not defined
hepatic dosing
- [no adjustment]
Peds Dosing .
Peds dosing is currently unavailable or not applicable for this drug.
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- hypersensitivity to ceftazidime
- caution: CrCl <50
- caution: antibiotic-associated colitis history, recent
Drug Interactions .
Overview
avibactam
beta-lactamase inhibitor
- OAT1 substrate
- OAT3 substrate
aztreonam
monobactam
- alters GI flora
- impairs immunomodulatory bacterial infective agent
Avoid/Use Alternative
- BCG live intravesical
- cholera vaccine, live
- fecal microbiota, live
- methotrexate
- probenecid
- typhoid vaccine, live
Monitor/Modify Tx
- warfarin
Caution Advised
- cabotegravir
- dichlorphenamide
- fexinidazole
- gemfibrozil
- lactulose
- leflunomide
- meropenem
- nitisinone
- pretomanid
- sodium picosulfate
- teriflunomide
- trimethoprim
- vaborbactam
- vadadustat
Adverse Reactions .
Serious Reactions
- hypersensitivity reaction
- anaphylaxis
- toxic epidermal necrolysis
- seizures
- encephalopathy
- C. difficile-associated diarrhea
- hepatitis
- neutropenia
- thrombocytopenia
- anemia
Common Reactions
- ALT or AST elevated
- anemia
- diarrhea
- hypokalemia
- fever
Safety/Monitoring .
Monitoring Parameters
Cr at baseline, then if renal impairment continue periodically; LFTs if hepatic impairment
Pregnancy/Lactation .
Pregnancy
Clinical Summary
aztreonam: may use during pregnancy; no human data available; no known risk of teratogenicity based on animal data at 2.7x and 3.6x MRHD
avibactam: weigh risk/benefit during pregnancy; no human data available; no known risk of teratogenicity, though possible risk of dose-dependent delayed ossification and decr. fetal wt based on conflicting animal data
Lactation
Clinical Summary
may use while breastfeeding; no known risk of infant harm based on limited human data; no human data available to assess effects on milk production
Pharmacology .
Metabolism: for aztreonam: minimal; CYP450: unknown; for avibactam: none; CYP450: none
Excretion: for aztreonam: urine primarily (64-76% unchanged), 12% feces; Half-life: 2h; for avibactam: urine primarily (84-100% unchanged); Half-life: 2h
Subclass: Beta-Lactamase Inhibitors ; Beta-Lactams ; Monobactams
Mechanism of Action
for aztreonam: binds to peptidoglycan, inhibiting cell wall synthesis; for avibactam: inhibits beta-lactamases, preventing beta-lactam degradation
Formulary .
No Formulary Selected
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