Monobactams

Monobactams are a class of beta-lactam antibiotics that are structurally different from other beta-lactam antibiotics (penicillins, cephalosporins, carbapenems). They contain a monocyclic beta-lactam ring as opposed to the bicyclic ring common to other beta-lactams. The only monobactam available for clinical use is Aztreonam.

History

Monobactams were first discovered in the 1970s in the culture broths of Gram-negative bacteria. The first monobactam antibiotic, Aztreonam, was approved for clinical use in 1986.

Mechanism of Action

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

Clinical Use

Monobactams, specifically Aztreonam, are used to treat infections caused by Gram-negative bacteria, including Pseudomonas aeruginosa. They are particularly useful in patients with allergies to other beta-lactam antibiotics, as they do not cross-react with these drugs.

Side Effects

Common side effects of monobactams include rash, nausea, diarrhea, and occasional liver enzyme abnormalities. Severe allergic reactions are rare.

Resistance

Resistance to monobactams can occur through the production of beta-lactamases, enzymes that break down the beta-lactam ring, rendering the antibiotic ineffective. Some bacteria also modify their PBPs to reduce the binding affinity of the antibiotic.

Monobactams Resources
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