Aztreonam

Summary

Aztreonam (CHEMBL158) is an approved small-molecule EC 2.4.1.129 (peptidoglycan glycosyltransferase) inhibitor (ATC J01DF01); indicated across 14 conditions including pneumonia and urinary tract infection.

At a glance

• Status: Approved (max clinical phase 4)
• Modality: Small molecule
• ATC class: J01DF01
• Indications: 14 conditions
• Clinical trials: 19
• Chemistry: 435.4 Da · C13H17N5O8S2

Identifiers

Drug identity and classification

Field	Value
ChEMBL ID	CHEMBL158
Name	Aztreonam
Type	Small molecule
Max phase	4
FDA approved	yes
PubChem CID	5742832
ChEBI	CHEBI:161680
ATC	J01DF01
Molecular formula	C13H17N5O8S2
Molecular weight	435.4
InChIKey	WZPBZJONDBGPKJ-VEHQQRBSSA-N

SMILES: C[C@H]1[C@@H](C(=O)N1S(=O)(=O)O)NC(=O)/C(=N\OC(C)(C)C(=O)O)/C2=CSC(=N2)N

IUPAC name: 2-[(Z)-[1-(2-amino-1,3-thiazol-4-yl)-2-[[(2S,3S)-2-methyl-4-oxo-1-sulfoazetidin-3-yl]amino]-2-oxoethylidene]amino]oxy-2-methylpropanoic acid

ChEBI definition: A synthetic monocyclic β-lactam antibiotic (monobactam), used primarily to treat infections caused by Gram-negative bacteria. It inhibits mucopeptide synthesis in the bacterial cell wall, thereby blocking peptidoglycan crosslinking.

Pharmacological roles (ChEBI): EC 2.4.1.129 (peptidoglycan glycosyltransferase) inhibitor, antibacterial drug, drug allergen.

Also known as: Azactam, Azonam, Aztreon, Aztreonam, Nebactam, NSC-646279, NSC-758913, Primbactam, SO 26776, SQ 26776, SQ-26776, aztreonam

Parent form; salt/anhydrous children: CHEMBL3833340

Patent coverage: 9,228 distinct patent families (34,706 SureChEMBL compound mentions), from 1 matched compound structure(s). Mentions count patents naming the compound (not distinct inventions), so promiscuous / reference molecules inflate the mention figure — families are the dedup metric.

Targets

Targets

Broader ChEMBL bioactivity targets: 4 (assay-derived). Sample: Ubiquitin carboxyl-terminal hydrolase 2, Inositol monophosphatase 1, Estrogen receptor, Penicillin-binding protein 1A.

Bioactivity

ChEMBL activities: 2 potent at pChembl ≥ 5 of 4 total. Top 30 by potency (10 = 0.1 nM, 6 = 1 µM):

Target	pChembl	Type	Value	Unit	Activity ID
P97697	8.4	Potency	4	nM	CHEMBL_ACT_4856719
Q07806	5.48	IC50	3340	nM	CHEMBL_ACT_14651892

Target pathways

No target-pathway data for this drug (no mapped target genes).

Indications & clinical

Indications

14 indications (7 at ChEMBL trial phase 4). Phase below is the highest clinical-trial phase recorded for this drug against each disease — not the molecule’s overall approval status (that is in the Summary).

Indication	Trial phase	MONDO	EFO
pneumonia	4	MONDO:0005249	EFO:0003106
urinary tract infection	4	MONDO:0100338	EFO:0003103
pyelonephritis	4	MONDO:0006939	EFO:1001141
bacterial infectious disease	4	MONDO:0005113	EFO:0000771
cystic fibrosis	4	MONDO:0009061	MONDO:0009061
skin disorder	3	MONDO:0005093	EFO:0000701
gonorrhea	2	MONDO:0004277	DOID:7551
gram-negative bacterial infections	2	MONDO:0021678	MONDO:0021678
kidney failure	1	MONDO:0001106	HP:0000083
non-small cell lung carcinoma	1	MONDO:0005233	EFO:0003060
osteomyelitis	0	MONDO:0005246	EFO:0003102

3 further indication records had no mapped disease name (EFO/MeSH-only) or were duplicates, and are omitted.

Clinical trials

Total trials: 19.

Phase distribution

Phase	Trials
PHASE3	6
PHASE4	4
PHASE1	3
PHASE2/PHASE3	2
PHASE2	2
PHASE1/PHASE2	1
Not specified	1

Top trials by phase / activity

NCT	Phase	Status	Title
NCT07004049	PHASE4	RECRUITING	Optimising TREATment for Severe Gram-Negative Bacterial Infections
NCT01659866	PHASE4	COMPLETED	Antibiotic Prophylaxis for Transrectal Prostate Biopsy
NCT02894684	PHASE4	COMPLETED	Aztreonam for Inhalation Solution (AZLI) for the Treatment of Exacerbations of Cystic Fibrosis
NCT03158116	PHASE4	TERMINATED	The Use of Inhaled Aztreonam in Children With a Tracheostomy Tube and Pseudomonas
NCT01499277	PHASE3	COMPLETED	Evaluation of Ceftaroline Fosamil Versus Vancomycin Plus Aztreonam in the Treatment of Patients With Skin Infections
NCT01811732	PHASE3	COMPLETED	Delafloxacin Versus Vancomycin and Aztreonam for the Treatment of Acute Bacterial Skin and Skin Structure Infections
NCT01984684	PHASE3	COMPLETED	Delafloxacin vs Vancomycin and Aztreonam for the Treatment of Acute Bacterial Skin and Skin Structure Infections
NCT02202135	PHASE3	TERMINATED	Evaluation of Ceftaroline Fosamil vs Vancomycin Plus Aztreonam in the Treatment of Patients With Skin Infections.
NCT02276482	PHASE3	COMPLETED	Study of Tedizolid Phosphate in Adolescents With Complicated Skin and Soft Tissue Infection (cSSTI) (MK-1986-012)
NCT03137173	PHASE3	COMPLETED	Ceftobiprole in the Treatment of Patients With Acute Bacterial Skin and Skin Structure Infections
NCT03867734	PHASE2/PHASE3	COMPLETED	Aztreonam for Pharyngeal Gonorrhea
NCT07113574	PHASE2/PHASE3	COMPLETED	Pharmacokinetics of Meropenem and Aztreonam After Intraperitoneal Administration Via Cycler-therapy in APD Patients Without Peritonitis
NCT00633152	PHASE2	COMPLETED	Efficacy and Safety of Ceftaroline Versus Linezolid in Subjects With Complicated Skin and Skin Structure Infections
NCT02730793	PHASE2	TERMINATED	Aztreonam Aerosol to Treat Cystic Fibrosis Nasal Disease
NCT03978091	PHASE1/PHASE2	COMPLETED	A Trial to Evaluate the Pharmacokinetics and Safety of AVYCAZ(R) in Combination With Aztreonam
NCT05777603	PHASE1	RECRUITING	Study of Aerosolized Antibiotics and Pembrolizumab in Advanced Non-small Cell Lung Cancer
NCT01689207	PHASE1	COMPLETED	To Investigate the Safety and Tolerability of Aztreonam-Avibactam (ATM-AVI)
NCT03376529	PHASE1	COMPLETED	Phase 1 Study to Evaluate DDI, PK, Safety, Tolerability of SPR741
NCT07204522	Not specified	RECRUITING	Efficacy of Empirical Anti-Infective Therapy in Neutropenic Febrile Patients.

Clinical evidence (CIViC)

No CIViC predictive evidence (expected for non-precision-medicine drugs).

Pharmacology

Pharmacogenomics

No PharmGKB pharmacogenomic data curated for this drug.

Related molecules

Related molecules

No competitor molecules sharing a primary target (ChEMBL phase ≥2 or PubChem drug-class).