ANTIMICROBIAL

BETA LACTAMASE INHIBITORS

- Have beta lactam ring

1. not used as antibacterial activity
2. only bind and inactivate the beta lactamase
- formulated in combination with beta lactamase sensitive antibiotics (antibiotic yg deactivated by b-lactamase)

BETA- CLAVULANIC ACID SULBACTAM TAZOBACTAM

LACTAMASE
INHIBITORS
BRAND Augmentin Timentin Unasyn plizer Zosyn: Wyeth
COMPOSITION Amoxicillin + clavulanate Ticarcillin + clavulanate Ampicillin + sulbactam Piperacillin + tazobactam
DOSAGE FORM - Pediatric oral suspension - Intravenous - IV - IV
- Chewable tablet and oral
suspension
- Tablet
- Extended-release tablet

DISEASE - Otitis media - Septicemia - Skin and skin - Appendicitis

- Comminuty required - Lower respiratory tract structure infection - Skin and skin structure
pneumonia of acute infection - Intra abdominal infection (including
bacterial sinusitis - Bone and joint infection diabetic foot infection)
- Sinusitis infection - Gyneocologic - Postpartum endometritis
- Skin and skin structure - UTI infection - Community required
infection - Gyneocologic pneumonia
- UTI infection - Hospital acquired
- Intra abdominal - Ventilator acquired
infection pneumonia
MICROBES - - - -
ANTIMICROBIAL

TYPES OF BETA LACTAMASE PRODUCE BY MICROBES

- Differences based on the structure of beta lactamase enzyme and its catalytic mechanisms

Class A Beta-Lactamase Class B Beta-Lactamase Class C Beta-Lactamase Class D Beta-Lactamase

- Plasmid mediated - Metalloenzyme - Chromosomally - Hydrolizing
resistance (transfer of (enzyme that encoded in most oxacillin
antimicrobial resistant required Zn2+ as a gram –ve bacteria
coding genes at the plasmid cofactor for - Eg:
by horizontal genes transfer) activity) - Cephalosporinase
- Spread widely among gram - Eg: imipenem
–ve
- Eg:
penacillinase-enzyme that
hydrolyse penicillin (higher
activity toward penicillin
than cephalosporins)

- Class A, C and D have serine bound acyl intermediate that catalyse the hydrolysis of Beta-lactam to an inactivated acid.
- Beta- lactamases are normally produce by Staphylococcus, Enterobacteriaceae, and Pseudomonas aeruginosa, certain anaerobic organism
and Bacteroides.