Monobactam
| Aztreonam | |
|---|---|
| Drug class | |
 | |
| 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.[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]
[6] Other monobactams include tigemonam,[7] 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[citation needed]
Pharmacology
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
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.[8] Monobactams can trigger seizures in patients with history of seizures, although the risk is lower than with penicillins.[citation needed]
Research
Siderophore-conjugated monobactams show promise for the treatment of multi drug-resistant pathogens.[9]
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.
- ^ a b c Murray, Patrick R.; Rosenthal, Ken S.; Pfaller, Michael A. (2021). Medical microbiology (9th ed.). Elsevier. p. 172. ISBN 978-0-323-67450-8.
- ^ a b c d 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.
- ^ a b c d "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)