Monobactam Explained

Aztreonam
Use:Bacterial infection
Atc Prefix:J01DF

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.[1]

Monobactams are narrow-spectrum antibiotics[2] effective only against (strictly or facultatively[3]) aerobic Gram-negative bacilli,[4] [5] 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.

[6] Other monobactams include tigemonam,[7] nocardicin A, and tabtoxin.

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.[8] 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.[9]

Notes and References

  1. Monobactams. Klaus R. Lindner. Daniel P. Bonner. William H. Koster. Kirk-Othmer Encyclopedia of Chemical Technology. Wiley-VCH. 10.1002/0471238961.1315141512091404.a01. 2000. 0471238961.
  2. Book: Murray, Patrick R. . Medical microbiology . Rosenthal . Ken S. . Pfaller . Michael A. . 2021 . Elsevier . 978-0-323-67450-8 . 9th . 172.
  3. Book: Sherris Medical Microbiology - 7th Edition . 437.
  4. Book: Ritter, James . Rang & Dale's Pharmacology . Flower . Rod . Henderson . Graeme . Loke . Yoon Kong . MacEwan . David . Rang . H. P. . 2020 . Elsevier . 978-0-7020-7448-6 . 9th . 665.
  5. Web site: Dictionnaire médical de l'Académie de Médecine . 2024-01-13 . www.academie-medecine.fr.
  6. Web site: Monobactams - Infectious Diseases . 2024-01-13 . MSD Manual Professional Edition . en.
  7. 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 . 10.1128/aac.32.3.346 . 172173 . 3259122.
  8. Book: Applied therapeutics : the clinical use of drugs.. Alldredge, Brian K.,, Revision of: Koda-Kimble, Mary Anne., Revision of: Young, Lloyd Y.. 9781609137137. Tenth. Philadelphia. 759179443. Alldredge. Brian K.. Corelli. Robin L.. Ernst. Michael E.. February 2012.
  9. Book: Gumienna-Kontecka . Elzbieta . Essential Metals in Medicine:Therapeutic Use and Toxicity of Metal Ions in the Clinic . Carver . Peggy L. . 2019 . Metal Ions in Life Sciences . de Gruyter GmbH . 978-3-11-052691-2 . Sigel . Astrid . 19 . Berlin . 181–202 . Chapter 7. Building a Trojan Horse: Siderophore-Drug Conjugates for the Treatment of Infectious Diseases . 10.1515/9783110527872-013 . 30855108 . Freisinger . Eva . Sigel . Roland K. O. . Carver . Peggy L. (Guest editor) . 73727689.

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