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β-Lactam antibiotics are indicated for the prevention and treatment of bacterial infections caused by susceptible organisms. At first, β-lactam antibiotics were mainly active only against gram-positive bacteria, yet the recent development of broad-spectrum β-lactam antibiotics active against various gram-negative organisms has increased their usefulness.
The β-lactam core structures. (A) A penam.(B) A carbapenam.(C) An oxapenam.(D) A penem.(E) A carbapenem.(F) A monobactam.(G) A cephem.(H) A carbacephem.(I) An oxacephem. This is a list of common β-lactam antibiotics—both administered drugs and those not in clinical use—organized by structural class.
Unlike the case of beta-lactam antibiotics, the inhibitors act as suicide substrates (tazobactam and sulbactam) which ultimately leads to the degradation of the beta-lactamase. [7] Avibactam on the other hand does not contain a beta-lactam ring (non beta-lactam beta-lactamase inhibitor), and instead binds reversibly. [8] [9]
Beta-lactamases (β-lactamases) are enzymes (EC 3.5.2.6) produced by bacteria that provide multi-resistance to beta-lactam antibiotics such as penicillins, cephalosporins, cephamycins, monobactams and carbapenems , although carbapenems are relatively resistant to beta-lactamase.
The β-lactam ring is not fused to another ring, in contrast to most other β-lactams. [ 1 ] Monobactams are narrow-spectrum antibiotics [ 2 ] effective only against (strictly or facultatively [ 3 ] ) aerobic Gram-negative bacilli , [ 4 ] [ 5 ] [ 3 ] exhibiting a high level of resistance to beta-lactamases of these organisms. [ 3 ]
Same mode of action as other beta-lactam antibiotics: disrupt the synthesis of the peptidoglycan layer of bacterial cell walls. Cefazolin: Ancef, Kefzol: Cephradine: Cephapirin: Cephalothin: Cefalexin: Keflex: Cephalosporins (Second generation) Cefaclor: Distaclor, Ceclor, Raniclor: Less Gram-positive cover, improved Gram-negative cover.
A lactam is a cyclic amide, and beta-lactams are named so because the nitrogen atom is attached to the β-carbon atom relative to the carbonyl. The simplest β-lactam possible is 2-azetidinone. β-lactams are significant structural units of medicines as manifested in many β-lactam antibiotics. [2]
Clavulanic acid is a β-lactam drug that functions as a mechanism-based β-lactamase inhibitor.While not effective by itself as an antibiotic, when combined with penicillin-group antibiotics, it can overcome antibiotic resistance in bacteria that secrete β-lactamase, which otherwise inactivates most penicillins.