Monobactams

ByBrian J. Werth, PharmD, University of Washington School of Pharmacy
Reviewed/Revised May 2024
View Patient Education

    Monobactams are parenteral beta-lactam bactericidal antibiotics.

    is currently the only available monobactam. Aztreonam

    • Enterobacterales that do not produce AmpC beta-lactamase, extended-spectrum beta-lactamase (ESBL), or Klebsiella pneumoniae carbapenemase (KPC)

    • Pseudomonas aeruginosa

    Aztreonam is not active against anaerobes. Gram-positive bacteria are resistant to aztreonam (in contrast to cephalosporins). Aztreonam acts synergistically with aminoglycosides.

    ceftazidimeaztreonam is used mainly for severe aerobic gram-negative bacillary infections (including meningitis) in patients who have a serious beta-lactam allergy but who nevertheless require beta-lactam therapy. Aztreonam is also not labile to metallo-beta-lactamases and can therefore be useful for some infections in which resistance to other beta-lactam antibiotics is mediated by that enzyme.

    Other antibiotics are added to cover any suspected gram-positive species or anaerobes.

    The dose of aztreonam is reduced in renal failure.

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