| Aztreonam | |
|---|---|
| Drug class | |
 Aztreonam. (The four-membered ring at the bottom is the β-lactam. There is a second thiazole ring, but it is not fused to the β-lactam ring.) | |
| Class identifiers | |
| Use | Bacterial infection |
| ATC code | J01DF |
| External links | |
| MeSH | D008997 |
| Legal status | |
| In Wikidata | |
Monobactams are bacterially-produced monocyclic β-lactam antibiotics. The β-lactam ring is not fused to another ring, in contrast to most other β-lactams.
Monobactams are narrow-spectrum antibiotics effective only against (strictly or facultatively) aerobic Gram-negative bacilli, exhibiting a high level of resistance to beta-lactamases of these organisms. Due to their narrow spectrum, monobactams can be used to treat infections by susceptible bacteria without disrupting the patient's microbiota. Monobactams are nevertheless seldom used.
Other monobactams include tigemonam, nocardicin A, and tabtoxin. An example of a monobactam that lacks antibiotic activity, but is used clinically for other purposes, is the cholesterol absorption inhibitor ezetimibe which is used to treat hypercholesterolemia
Pharmacology
Monobactams exert their antibacterial effects by binding to penicillin-binding proteins (PBPs), thereby inhibiting bacterial wall synthesis. Monobactams exhibit poor affinity for PBPs of Gram-positive bacteria as well as of strictly anaerobic bacteria, resulting in a lack of significant antimicrobial activity against these kinds of organisms. Monobactams are synergetic with aminoglycosides, and piperacillin.
Bacterial resistance to monobactams have been observed, and is mediated by bacterial beta-lactamases.
Adverse effects
Adverse effects to monobactams can include skin rash and occasional abnormal liver functions.
Monobactam antibiotics exhibit no IgE cross-reactivity reactions with penicillin but have shown some cross reactivity with cephalosporins, most notably ceftazidime, which contains an identical side chain as aztreonam. Monobactams can trigger seizures in patients with history of seizures, although the risk is lower than with penicillins.
Research
Siderophore-conjugated monobactams show promise for the treatment of multi drug-resistant pathogens.
References
- Klaus R. Lindner; Daniel P. Bonner; William H. Koster (2000). "Monobactams". Kirk-Othmer Encyclopedia of Chemical Technology. Wiley-VCH. doi:10.1002/0471238961.1315141512091404.a01. ISBN 0471238961.
- ^ Murray, Patrick R.; Rosenthal, Ken S.; Pfaller, Michael A. (2021). Medical microbiology (9th ed.). Elsevier. p. 172. ISBN 978-0-323-67450-8.
- ^ Sherris Medical Microbiology - 7th Edition. p. 437.
- Ritter, James; Flower, Rod; Henderson, Graeme; Loke, Yoon Kong; MacEwan, David; Rang, H. P. (2020). Rang & Dale's Pharmacology (9th ed.). Elsevier. p. 665. ISBN 978-0-7020-7448-6.
- ^ "Dictionnaire médical de l'Académie de Médecine". www.academie-medecine.fr. Retrieved 2024-01-13.
- "Monobactams - Infectious Diseases". MSD Manual Professional Edition. Retrieved 2024-01-13.
- Fuchs PC, Jones RN, Barry AL (March 1988). "In vitro antimicrobial activity of tigemonam, a new orally administered monobactam". Antimicrob. Agents Chemother. 32 (3): 346–9. doi:10.1128/aac.32.3.346. PMC 172173. PMID 3259122.
- Alldredge, Brian K.; Corelli, Robin L.; Ernst, Michael E. (February 2012). Applied therapeutics : the clinical use of drugs. Alldredge, Brian K.,, Revision of: Koda-Kimble, Mary Anne., Revision of: Young, Lloyd Y. (Tenth ed.). Philadelphia. ISBN 9781609137137. OCLC 759179443.
{{cite book}}: CS1 maint: location missing publisher (link) - Gumienna-Kontecka, Elzbieta; Carver, Peggy L. (2019). "Chapter 7. Building a Trojan Horse: Siderophore-Drug Conjugates for the Treatment of Infectious Diseases". In Sigel, Astrid; Freisinger, Eva; Sigel, Roland K. O.; Carver, Peggy L. (Guest editor) (eds.). Essential Metals in Medicine:Therapeutic Use and Toxicity of Metal Ions in the Clinic. Vol. 19. Berlin: de Gruyter GmbH. pp. 181–202. doi:10.1515/9783110527872-013. ISBN 978-3-11-052691-2. PMID 30855108. S2CID 73727689.
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External links
- Monobactams at the U.S. National Library of Medicine Medical Subject Headings (MeSH)