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Monobactams
Monobactams belong to a group of monocyclic β-lactams. Monobactams are obtained from the bacteria Chromobacterium violaceum. Among monobactams only aztreonam is currently used in clinical practice. It possesses a narrow spectrum of antibacterial activity and is used to treat infections caused by gram-negative aerobic flora.
Spectrum of activity
Action mechanism is associated with suppressing the formation of bacterial cell wall. Aztreonam is resistant to many β-lactamases produced by gram-negative flora. It is effective against Enterobacteriaceae and P.aeruginosa resistant to nosocomial strains resistant to cephalosporins, aminoglycosides. It does not act on acynetobacter, S.maltophilia, B.cepacia, gram-positive cocci and anaerobs.
Indications
Monobactams are indicated for the treatment of lower respiratory tract infections, intra-abdominal infections, pelvic organ infections, urogenital infections, skin and soft tissue infections, sepsis. Monobactams are actively used in combination with other preparations for the treatment of mixed infections.
Contraindications:
Monobactams are contraindicated for patients with known reactions of hypersensitivity to monobactams or beta-lactam antibiotics. They should be used with caution in patients with liver and kidney diseases.
Cautions:
- Pregnancy. The most of monobactams pass through placenta and enter systemic circulation of the fetus. The safety of monobactams in pregnant women has not been established, and the use of monobactams during pregnancy is not recommended
- Breastfeeding. Monobactams pass though breast milk and therefore the use of the medication is contraindicated
- Monobactams should be used with caution in pediatric and geriatric patients; in patient with hepatic or renal failure
Side effects
The most common side effects typical for monobactams include:
- Digestive system: stomach pain, nausea, diarrhea
- Liver: jaundice, hepatitis
- CNS: headache, drowsiness, confusion, insomnia
- Allergic reactions: skin rash, hives, anaphylactic shock
- Local reactions: phlebitis, pain in the injection site (in parenteral form of administration)
Drug interactions:
It is not recommended to combine the medication with carbapenems