Gross et al reported a simple method of dosing aztreonam in a patient with end-stage renal failure on hemodialysis. The authors are from the University of Illinois at Chicago and AstraZeneca.
Patient selection: end-stage renal disease (creatinine clearance < 10 mL per min per 1.73 square meter) on hemodialysis
Dosing regimen for aztreonam:
(1) 1 to 2 grams once daily
(2) if hemodialysis performed on that day, then the dose is given after the dialysis is complete
Performance: > 90% of target, up to an MIC of 4-8 mg/L (4 mg/L for 1 g/day; 8 mg/L for 2 g/day).
Dosing 2 grams of aztreonam 3 times a week is only adequate if the infection is non-severe and the organism is susceptible (MIC is <= 0.5 mg/L).
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