3.8 Monobactams
Like penicillins, cephalosporins, and carbapenems, monobactams also have a beta-lactam ring structure.
Mechanism of Action: Monobactams are bactericidal and work to inhibit bacterial cell wall synthesis.[1]
Indications: Monobactams are narrow-spectrum antibacterial medications that are used primarily to treat gram-negative bacteria such as Pseudomonas aeruginosa.
Nursing Considerations: Clients taking monobactams may experience adverse effects similar to other beta-lactam medications, so nurses should monitor for GI upset, skin sensitivities, and coagulation abnormalities.
Side Effects/Adverse Effects: Common side effects related to the use of monobactams include nausea, vomiting, diarrhea, and abdominal pain. Additional adverse effects include skin rash and abnormal metallic or sour taste in the mouth.
Health Teaching & Health Promotion: Clients should monitor for signs of superinfection (such as vaginal itching or discharge indicating a yeast infection or loose or foul-smelling stool indicating C-diff) and report any occurrence to the provider. If the client experiences fever and bloody diarrhea, they should contact the provider immediately. The client should also be advised to notify the provider immediately if symptoms progress or if any sign of allergic response occurs.[2]
Now let’s take a closer look at the medication grid for aztreonam in Table 3.8.[3]
Table 3.8 Monobactam Medication Grid
| Class/Subclass | Prototype/Generic | Nursing Considerations | Therapeutic Effects | Side/Adverse Effects |
|---|---|---|---|---|
| Monobactams | aztreonam | Check for severe allergies to any beta lactams – penicillin, cephalosporins, or carbapenems – because cross-sensitivity can occur
Can be administered IM, IV, or via inhalation |
Monitor for systemic signs of infection:
-WBCs -Fever Monitor actual site of infection Monitor culture results, if obtained |
Similar to cephalosporins |
Critical Thinking Activity 3.8
Using the above grid information, consider the following clinical scenario question:
A client with cystic fibrosis is diagnosed with ventilator-associated pneumonia and is prescribed aztreonam (Azactam) 1 gm IV daily for a suspected Pseudomonas aeruginosa infection. The nurse reviews the culture results that just arrived and notices that the results indicate the infection is caused by Methicillin-resistant Staphylococcus aureus. Will this medication be effective against this bacterium? What is the nurse’s next best response?
Note: Answers to the Critical Thinking activities can be found in the “Answer Key” section at the end of the book.
- This work is a derivative of Microbiology by OpenStax licensed under CC BY 4.0. Access for free at https://openstax.org/books/microbiology/pages/1-introduction ↵
- uCentral from Unbound Medicine. https://www.unboundmedicine.com/ucentral ↵
- This work is a derivative of DailyMed by U.S. National Library of Medicine in the Public Domain. ↵
