Merck Manual

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Monobactams

By

Brian J. Werth

, PharmD, University of Washington School of Pharmacy

Last full review/revision May 2020| Content last modified May 2020
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Monobactams are parenteral beta-lactam bactericidal antibiotics.

Aztreonam is currently the only available monobactam. Aztreonam has activity similar to that of ceftazidime against

  • Enterobacteriaceae that do not produce AmpC beta-lactamase, extended-spectrum beta-lactamase (ESBL), or Klebsiella pneumoniae carbapenemase (KPC)

Aztreonam is not active against anaerobes. Gram-positive bacteria are resistant to aztreonam (in contrast to cephalosporins). Aztreonam acts synergistically with aminoglycosides.

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) 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.

Drugs Mentioned In This Article

Drug Name Select Trade
FORTAZ, TAZICEF
AZACTAM
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NOTE: This is the Professional Version. CONSUMERS: Click here for the Consumer Version

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