Monobactam
| Aztreonam | |
|---|---|
| Drug class | |
| File:Aztreonam structure.svg | |
| Class identifiers | |
| Use | Bacterial infection |
| ATC code | J01DF |
| External links | |
| MeSH | D008997 |
| Legal status | |
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][3] exhibiting a high level of resistance to beta-lactamases of these organisms.[3] Due to their narrow spectrum, monobactams can be used to treat infections by susceptible bacteria without disrupting the patient's microbiota.[2] Monobactams are nevertheless seldom used.[2]
Aztreonam is the archetypal monobactam.[6] Other monobactams include tigemonam,[7] nocardicin A, carumonam 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.[8]
Pharmacology
[edit | edit source]Monobactams exert their antibacterial effects by binding to penicillin-binding proteins (PBPs), thereby inhibiting bacterial wall synthesis.[5] 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.[3] Monobactams are synergetic with aminoglycosides, and piperacillin.[5]
Bacterial resistance to monobactams have been observed, and is mediated by bacterial beta-lactamases.[5]
Adverse effects
[edit | edit source]Adverse effects to monobactams can include skin rash and occasional abnormal liver functions.[citation needed]
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.[9] Monobactams can trigger seizures in patients with history of seizures, although the risk is lower than with penicillins.[citation needed]
Research
[edit | edit source]Siderophore-conjugated monobactams show promise for the treatment of multi drug-resistant pathogens.[10]
References
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External links
[edit | edit source]- Monobactams at the U.S. National Library of Medicine Medical Subject Headings (MeSH)