Effects of beta-lactamase-mediated antimicrobial resistance: the role of beta-lactamase inhibitors.

Abstract

Production of beta-lactamase is the most common mechanism of bacterial resistance to beta-lactam antibiotics. Virtually all bacteria have the capability of synthesizing the enzyme. Microorganisms may already possess the native genetic information necessary for beta-lactamase production (i.e., chromosomal), or may acquire the capacity by transfer of DNA from another organism (i.e., plasmid-mediated). The level of beta-lactamase production may be stable and noninducible (constitutive enzyme production), or may be stimulated on exposure to selected beta-lactam antibiotics (inducible enzyme production). Inhibitors such as clavulanic acid and sulbactam prevent antibiotic degradation by the beta-lactamases of many clinically significant pathogens. Therefore, currently available beta-lactam-beta-lactamase-inhibitor combinations exhibit broad spectra of in vitro activity. Ticarcillin-clavulanate possesses clinically significant activity against many bacteria, including streptococci, Staphylococcus aureus, Bacteroides fragilis, and numerous Enterobacteriaceae. Amoxicillin-clavulanate and ampicillin-sulbactam demonstrate clinically significant activity against streptococci (including enterococci), S. aureus, B. fragilis, and some Enterobacteriaceae. Ticarcillin-clavulanate is indicated for treatment of serious infections, including septicemia. Amoxicillin-clavulanate is useful in the treatment of upper respiratory, urinary tract, and skin and soft tissue infections. Ampicillin-sulbactam may be used for treatment of intraabdominal, gynecologic, urinary tract, and skin and soft tissue infections.

• Authors: M S Maddux
• Journal: Pharmacotherapy (Pharmacotherapy) Vol. 11 Issue 2 ( Pt 2) Pg. 40S-50S ( 1991) ISSN: 0277-0008 [Print] United States
• PMID: 2041831 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't, Review)

Chemical References

• Bacterial Proteins
• Carrier Proteins
• Drug Combinations
• Penicillin-Binding Proteins
• beta-Lactamase Inhibitors
• Peptidyl Transferases
• Hexosyltransferases
• Muramoylpentapeptide Carboxypeptidase
• beta-Lactamases

Topics

• Bacteria (drug effects, enzymology)
• Bacteria, Anaerobic (enzymology)
• Bacterial Proteins
• Carrier Proteins (classification, pharmacology)
• Chromosomes (enzymology)
• Drug Combinations
• Drug Resistance, Microbial
• Gram-Negative Bacteria (enzymology)
• Gram-Positive Bacteria (enzymology)
• Hexosyltransferases
• Muramoylpentapeptide Carboxypeptidase (classification, pharmacology)
• Penicillin-Binding Proteins
• Peptidyl Transferases
• Plasmids
• beta-Lactamase Inhibitors
• beta-Lactamases (biosynthesis, classification)