Monobactam

Monobactam is a type of antibiotic that is structurally different from other antibiotics. It is a beta-lactam antibiotic that is resistant to beta-lactamase, an enzyme produced by certain bacteria that can inactivate other beta-lactam antibiotics. Monobactam antibiotics are used to treat infections caused by Gram-negative bacteria, including Pseudomonas aeruginosa and Enterobacteriaceae.

History

Monobactams were first discovered in the 1970s in the soil bacterium Chromobacterium violaceum. The first monobactam antibiotic to be developed for clinical use was Aztreonam, which was approved by the Food and Drug Administration (FDA) in 1986.

Structure and Mechanism of Action

Monobactams have a unique monocyclic beta-lactam structure, which is different from the bicyclic structure of other beta-lactam antibiotics such as penicillins and cephalosporins. This unique structure makes monobactams resistant to beta-lactamase enzymes.

Monobactams work by inhibiting the synthesis of the bacterial cell wall, leading to cell death. They bind to penicillin-binding proteins (PBPs) in the bacterial cell wall, preventing the cross-linking of peptidoglycan chains, which are essential for bacterial cell wall strength and rigidity.

Clinical Use

Monobactams are primarily used to treat infections caused by Gram-negative bacteria, including Pseudomonas aeruginosa and Enterobacteriaceae. They are particularly useful in treating infections in patients who are allergic to other beta-lactam antibiotics, as they do not cross-react with these antibiotics.

Side Effects and Contraindications

Common side effects of monobactams include gastrointestinal disturbances, skin rashes, and hypersensitivity reactions. They are contraindicated in patients with a known hypersensitivity to monobactams.

Resistance

Resistance to monobactams can occur through several mechanisms, including the production of beta-lactamase enzymes that can inactivate the antibiotic, alterations in PBPs, and changes in the permeability of the bacterial cell wall.

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