RT Book, Section
A1 Gruenberg, Katherine
A1 Guglielmo, B. Joseph
A2 Papadakis, Maxine A.
A2 McPhee, Stephen J.
A2 Rabow, Michael W.
A2 McQuaid, Kenneth R.
SR Print(0)
ID 1184154096
T1 Other Beta-Lactam Medications
T2 Current Medical Diagnosis & Treatment 2022
YR 2022
FD 2022
PB McGraw-Hill Education
PP New York, NY
SN 9781264269389
LK accessmedicine.mhmedical.com/content.aspx?aid=1184154096
RD 2024/04/24
AB Aztreonam  is  the  sole  marketed  monobactam,  so  named  due  its  monocyclic  beta-lactam  ring  resistant  to  many  beta-lactamases.  Aztreonam  is  active  against  gram-negative  organisms  (including  Pseudomonas)  but  has  no  activity  against  gram-positive  organisms  or  anaerobes.  Aztreonam  resembles  ceftazidime  with  its  gram-negative  activity.  Thus,  it  is  generally  strong  against  E  coli,  Klebsiella,  Proteus,  and  Pseudomonas  spp,  but  its  activity  is  unpredictable  against  Acinetobacter,  Enterobacter,  and  Citrobacter  spp.  Clinical  uses  of  aztreonam  are  limited  because  of  the  availability  of  third-generation  cephalosporins  with  a  broader  spectrum  of  activity  and  minimal  toxicity.  However,  the  clinical  role  of  aztreonam  may  expand;  it  is  being  investigated  in  combination  with  the  beta-lactamase  inhibitor  avibactam  for  the  management  of  metallo-beta-lactamase–producing  Enterobacteriaceae  (eg,  E  coli,  Klebsiella,  Proteus),  for  which  few  other  therapies  are  available.  Considering  its  activity  against  P  aeruginosa,  aztreonam  is  also  useful  in  the  management  of  patients  with  cystic  fibrosis  as  an  inhaled  dose  of  75  mg  administered  three  times  daily.  Despite  the  structural  similarity  of  aztreonam  to  penicillin,  IgE  cross-reactivity  does  not  exist,  and  it  can  therefore  be  used  in  patients  with  IgE-mediated  penicillin  allergy.