Monobactams are parenteral beta-lactam Beta-Lactams Beta-lactams are antibiotics that have a beta-lactam ring nucleus. Subclasses include Carbapenems Cephalosporins and cephamycins (cephems) Clavams Monobactams read more bactericidal antibiotics Overview of Antibacterial Drugs Antibacterial drugs are derived from bacteria or molds or are synthesized de novo. Technically, “antibiotic” refers only to antimicrobials derived from bacteria or molds but is often (including... read more .
Aztreonam is currently the only available monobactam. Aztreonam has activity similar to that of ceftazidime against
Enterobacterales 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 Cephalosporins Cephalosporins are bactericidal beta-lactam antibiotics. They inhibit enzymes in the cell wall of susceptible bacteria, disrupting cell wall synthesis. There are 5 generations of cephalosporins... read more ). Aztreonam acts synergistically with aminoglycosides Aminoglycosides Aminoglycosides have concentration-dependent bactericidal activity. These antibiotics bind to the 30S ribosome, thereby inhibiting bacterial protein synthesis. Spectinomycin is a bacteriostatic... read more .
Aztreonam shares structural similarities with few other beta-lactams, making cross-hypersensitivity unlikely, except with ceftazidime and cefiderocol, which have similar R1 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 to other beta-lactam antibiotics 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.