Monobactams

Learning Objectives
• Describe chemical structure of monobactams
Chemical structure of
monobactam
• Monobactams are β-lactam compounds
wherein the β-lactam ring is alone and not
fused to another ring.
• They work only against aerobic Gram
negative bacteria.
Monobactams
Spectrum of Activity
• Prototype drug: Aztreonam (the only monobactam in clinical use)
• Aztreonam bind preferentially to PBP 3 of gram-negative aerobes
• has little to no activity against gram-positives or anaerobes
• Has synergictic effects with aminoglycosides

• Spectrum
• Gram-negative
• E. coli, K. pneumoniae, P. mirabilis, H. influenzae, M. catarrhalis,
Enterobacter, Citrobacter, Providencia, Salmonella, Shigella and Pseudomonas
aeruginosa

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Monobactams
Clinical Uses

 Urinary tract infections, lower respiratory tract infections, meningitis,

bacteremia, skin and soft tissue infections, and intraabdominal
infections, gynaecological infections caused by susceptible gram-
negatives
 Penicillin-allergic patients who require antibiotic with gram-negative
coverage
 Patients who cannot tolerate aminoglycosides because of renal
insufficiency

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 Adverse effects
 G.I Tract symptoms
 Superinfections (pseud