Vol. 24 No. 1 (2025)
Literature Review

Monobactams Update on Aztreonam and Prospects for Development of New Drugs

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  • Catarina P. V. Lima,
  • Tamara T. de S. L. Tartaglia,
  • Sarah M. M. Fialho,
  • Débora de S. M. Breder,
  • Andréia P. Gomes,
  • Jorge L. D. Gazineo,
  • Adriano S. B. Castro,
  • Eduardo V. V. Varejão,
  • Bruna S. de S. L. Rodrigues,
  • Rodrigo Siqueira-Batista
Catarina P. V. Lima
Faculdade de Medicina, Faculdade Dinâmica do Vale do Piranga (FADIP), Ponte Nova, MG, Brasil.
Tamara T. de S. L. Tartaglia
Faculdade de Medicina, Faculdade Dinâmica do Vale do Piranga (FADIP), Ponte Nova, MG, Brasil.
Sarah M. M. Fialho
Faculdade de Medicina, Faculdade Dinâmica do Vale do Piranga (FADIP), Ponte Nova, MG, Brasil.
Débora de S. M. Breder
Faculdade de Medicina, Faculdade Dinâmica do Vale do Piranga (FADIP), Ponte Nova, MG, Brasil.
Andréia P. Gomes
Departamento de Medicina e Enfermagem, Universidade Federal de Viçosa, Viçosa, MG, Brasil.
Jorge L. D. Gazineo
Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brasil.
Adriano S. B. Castro
Bio
Eduardo V. V. Varejão
Departamento de Química, Universidade Federal de Viçosa, Viçosa, MG, Brasil.
Bruna S. de S. L. Rodrigues
Faculdade de Medicina, Faculdade Dinâmica do Vale do Piranga (FADIP), Ponte Nova, MG, Brasil.
Rodrigo Siqueira-Batista
Departamento de Medicina e Enfermagem, Universidade Federal de Viçosa, Viçosa, MG, Brasil.
Bio
DOI: https://doi.org/10.12957/bjhbs.2025.93437

Published 2025-08-08

Keywords

  • aztreonam,
  • beta-lactams,
  • monobactams

How to Cite

1.
Lima C, Tartaglia T, Fialho S, Breder D, Gomes A, Gazineo J, Castro A, Varejão E, Rodrigues B, Siqueira-Batista R. Monobactams Update on Aztreonam and Prospects for Development of New Drugs. BJHBS [Internet]. 2025 Aug. 8 [cited 2025 Nov. 1];24(1):38-4. Available from: https://bjhbs.hupe.uerj.br/bjhbs/article/view/207

Copyright (c) 2025 Brazilian Journal of Health and Biomedical Sciences

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Abstract

Introduction: Monobactams belong to the beta-lactam group and are drugs indicated for the treatment of infections caused by aerobic Gram-negative bacteria. Aztreonam is currently the only available representative, and due to its clinical safety profile, efforts have been directed towards the development of new antibacterials in this class. Methodology: This is a narrative literature review, gathering articles, books, and documents from various sources in Portuguese, English, and Spanish. The analysis focused on relevant data regarding aztreonam and related compounds, addressing the main aspects of aztreonam – brief history, chemical structure, mechanism of action, pharmacokinetics, pharmacodynamics, spectrum of action, resistance mechanisms, drug interactions, clinical indications, dosage, use in special situations, and adverse effects – along with presenting the potential of the aztreonam-avibactam combination and the development of new monobactams. Results and Discussion: Aztreonam has a unique chemical structure, containing a monocyclic beta-lactam ring. Its bactericidal action occurs through the inhibition of penicillin-binding protein-3 (PBP-3), affecting the cell wall synthesis of Gram-negative bacteria. The drug is generally well-tolerated, with mild adverse effects. Combinations like aztreonam-avibactam are promising for treating infections caused by multidrug-resistant bacteria. Studies highlight the need for new compounds, such as LYS228 and BAL30072, which expand the spectrum of action and overcome resistance mechanisms. Conclusion: Aztreonam remains relevant in antimicrobial therapy against Gram-negative infections. The development of new monobactams is a strategy to address increasing bacterial resistance and improve the treatment of complex infections.

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