Briefing Note: aztreonam (Cayston)

SMC did not accept aztreonam lysine for the suppressive therapy of chronic pulmonary infections due to Pseudomonas aeruginosa in patients with cystic fibrosis (CF) aged 18 years and older, who
cannot be treated with colistin.

• Cystic fibrosis (CF) is a life-threatening inherited disease that affects the mucus glands of internal organs, especially the lungs, but also of the liver, pancreas, and the digestive system. CF in the lungs leads to them clogging with thick sticky mucus. Many people with CF have a chronic respiratory infection caused by a bacteria called Pseudomonas aeruginosa that settles into the thick mucus and makes it hard to breathe.
• Aztreonam lysine is an inhaled antibiotic used to help reduce infection and improve breathing symptoms in people with CF who have P. aeruginosa in their lungs. It is taken three times a day.
• Studies have shown that aztreonam lysine improved breathing symptoms over 28 days compared with placebo (a dummy medicine containing no active treatment) and another antibiotic. It is unclear whether or not the benefit is long term.
• A greater proportion of patients given aztreonam lysine experienced side effects thought to be due to the medicine, compared with patients given the other antibiotic.
• SMC did not accept aztreonam lysine for use in NHSScotland because the balance of costs and benefits meant the medicine was not value for money.

13 February 2012