Merck Manual

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Monobactams

By

Brian J. Werth

, PharmD, University of Washington School of Pharmacy

Last full review/revision May 2020
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Aztreonam is currently the only available monobactam. Aztreonam has activity similar to that of ceftazidime against

Aztreonam shares structural similarities with few other beta-lactams, making cross-hypersensitivity unlikely, except with ceftazidime and cefiderocol, which have similar R-1 side chains. Thus, aztreonam is used mainly for severe aerobic gram-negative bacillary infections (including meningitis Acute Bacterial Meningitis Acute bacterial meningitis is rapidly progressive bacterial infection of the meninges and subarachnoid space. Findings typically include headache, fever, and nuchal rigidity. Diagnosis is by... read more ) in patients who have a serious beta-lactam allergy but who nevertheless require beta-lactam therapy. Aztreonam is also not labile to metallo-beta-lactamases and can therefore be useful for some infections in which resistance is mediated by that enzyme.

Other antibiotics are added to cover any suspected gram-positive species or anaerobes.

The dose of aztreonam is reduced in renal failure.

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