A nebulised antibiotic for cystic fibrosis
Aztreonam (inhaled)
A nebulised antibiotic used in cycles for chronic Pseudomonas lung infection in cystic fibrosis.
What is Aztreonam (inhaled)?
Inhaled aztreonam is an antibiotic that is breathed in as a fine mist using a special nebuliser, to treat long-term Pseudomonas lung infection in people with cystic fibrosis. Delivering the antibiotic straight to the lungs helps control this stubborn infection while keeping the amount in the rest of the body low. It is given in cycles, with on and off periods, as directed by the cystic fibrosis team. Because it can cause wheeze or chest tightness, a reliever (bronchodilator) inhaler is used first, and the medicine is prepared and nebulised using the specific device provided.
Education and reference only. This is a plain-language guide to Aztreonam (inhaled) — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Inhaled aztreonam is an antibiotic given as a nebulised mist that is breathed directly into the lungs. It is used in people with cystic fibrosis who have a chronic (long-term) lung infection with a bacterium called Pseudomonas aeruginosa, which is common and difficult to clear in cystic fibrosis. By treating the lungs directly, it helps keep this infection under control, supporting lung health and reducing flare-ups. It is used with a specific nebuliser system, given in repeating cycles managed by the specialist cystic fibrosis team.
How it works
Aztreonam is an antibiotic that kills the bacteria causing the lung infection by interfering with how they build their protective cell wall. Breathing it in as a mist delivers it straight to the airways where the Pseudomonas infection sits, achieving good levels in the lungs while keeping the amount absorbed into the rest of the body relatively low. Treating long-term Pseudomonas this way helps suppress the infection over time, which is why it is used in repeating on-and-off cycles rather than as a one-off course.
Company & origin
Originated / developed by: Specialist medicine.
A nebulised antibiotic used in the UK to treat chronic Pseudomonas lung infection in people with cystic fibrosis.
Practical use
How to take Aztreonam (inhaled)
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Use a reliever (bronchodilator) inhaler first, as advised, to help prevent wheeze or chest tightness from the nebulised antibiotic.
- Prepare and breathe it in using only the specific nebuliser device you were given, mixing it just before use.
- Follow the cycle you are given, usually a set time on treatment followed by a set time off, repeated as directed.
- Fit it in with your other inhaled treatments and airway clearance in the order your cystic fibrosis team recommends.
- Clean and look after your nebuliser device as instructed, and tell your team about any allergy to this or related antibiotics.
Weighing it up
Advantages & disadvantages of Aztreonam (inhaled)
Advantages
- Delivers antibiotic straight to the lungs to control chronic Pseudomonas infection in cystic fibrosis.
- Keeps the amount absorbed into the rest of the body relatively low compared with tablets or drips.
- Given in convenient repeating cycles as part of a specialist care plan.
Disadvantages
- Can cause wheeze or chest tightness, so a reliever inhaler is needed first.
- Requires a specific nebuliser device, careful preparation and regular cleaning.
- Cough, sore throat or a change in voice can occur, and it must be used in set cycles.
Practical use
Good to know
Inhaled aztreonam is a specialist treatment that works best as part of the wider cystic fibrosis care plan, tailored to the person by their CF team. A key practical point is that nebulising the antibiotic can sometimes cause wheeze or chest tightness, so a reliever (bronchodilator) inhaler is taken first to open the airways; if you do other inhaled treatments and airway clearance (physiotherapy), there is usually a recommended order, which your team will set out. It is given in cycles, typically a set period on treatment followed by a set period off, repeated over time. It must be prepared and used with the specific nebuliser device provided, mixing the medicine just before use, and the device needs proper cleaning. Tell your team if you have a true allergy to it or related antibiotics. It is breathed in rather than swallowed, so the usual side effects of antibiotic tablets are less of an issue, but cough, a sore throat and a change in voice can occur.
Who should not take it / use with caution
- It is not suitable for people with a known allergy to aztreonam or closely related antibiotics.
- It is used with caution in people who wheeze badly with nebulised treatments, with airways opened first.
- Its use in young children and in pregnancy is guided by the specialist team after assessment.
Monitoring
- Reviewing how well the chronic lung infection is controlled and how breathing tests respond.
- Watching for wheeze or chest tightness, particularly when first starting.
- Checking inhaler and nebuliser technique and that the device is being cleaned properly.
Side effects
- Cough, wheeze, chest tightness, a sore throat and a change in voice can occur.
- A blocked or runny nose and a mild fever are sometimes reported.
- Less often, an allergic reaction or a marked drop in breathing test results, which should be reported.
Key interactions
- There are few important interactions because little is absorbed into the rest of the body.
- It is used alongside other inhaled treatments and airway clearance in a recommended order.
- Tell your team about all your medicines, including other nebulised or inhaled treatments.
Available as: A powder mixed with a liquid just before use and breathed in as a mist using a specific nebuliser device.
Answers
Aztreonam (inhaled): frequently asked questions
Why do I use a reliever inhaler before it?
Nebulising the antibiotic can sometimes cause wheeze or chest tightness, so a reliever (bronchodilator) inhaler is used first to open the airways and help prevent this.
Why is it given in cycles?
Chronic Pseudomonas infection is suppressed rather than cured, so it is given in repeating on-and-off cycles over time, as directed by your cystic fibrosis team.
Can I use any nebuliser?
No. It must be prepared and breathed in using the specific nebuliser device you were given, mixed just before use, and the device needs proper cleaning.
Does it cause the usual antibiotic side effects?
Because it is breathed in rather than swallowed, little is absorbed into the rest of the body, so tablet-type side effects are less of an issue, though cough, sore throat and voice changes can occur.
Where does it fit with my other treatments?
Your cystic fibrosis team will tell you the order for your inhaled treatments and airway clearance (physiotherapy), so it fits in safely with the rest of your routine.
Authoritative sources
- BNF
- NICE CKS
Building a medicines information resource?
We create evidence-led, dose-free drug and formulary references for teams.