Cayston now indicated from six years

Cayston (aztreonam) has been licensed for use in children aged six years and over with cystic fibrosis (CF).

Cayston should only be used with the Altera nebuliser handset and Altera aerosol head connected to an eBase controller or an eFlow rapid control unit. | SCIENCE PHOTO LIBRARY
Cayston should only be used with the Altera nebuliser handset and Altera aerosol head connected to an eBase controller or an eFlow rapid control unit. | SCIENCE PHOTO LIBRARY

The antibiotic is indicated for the treatment of chronic pulmonary infections due to Pseudomonas aeruginosa. The dosage schedule in children is the same as in adults: 75mg three times daily for 28 days, followed by a 28-day treatment-free period.

Tobramycin comparison study

Paediatric use of inhaled aztreonam was assessed in an active-controlled multicentre study (GS-US-205-0110). Patients with CF and P. aeruginosa lung infection (n=273) were randomised to receive aztreonam 75mg by inhalation three times a day or tobramycin nebuliser solution 300mg twice daily, for three cycles of 28 days on therapy followed by 28 days off therapy. Of the 268 patients who completed the study, 209 were aged 6 to 17 years.

The adjusted mean change from baseline in forced expiratory volume in one second (FEV1) % predicted across three treatment courses was 2.05% and –0.66% in the aztreonam and tobramycin groups, respectively (treatment difference: 2.70; p=0.002; 95% CI 0.98–4.43). The aztreonam group showed a longer time to requirement for intravenous antipseudomonal antibiotics related to respiratory events than the tobramycin group (p=0.003), as well as fewer hospitalisations due to respiratory events (40 vs 58; p=0.044).

Significantly greater improvements in CFQ-R respiratory symptom scores were also observed with aztreonam versus tobramycin (6.3 vs 2.2; p=0.019).

View Cayston drug record

Further information: Gilead

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