Beta-lactamases and beta-lactamase inhibitors

Int J Antimicrob Agents. 1999 Aug:12 Suppl 1:S3-7; discussion S26-7. doi: 10.1016/s0924-8579(99)00085-0.

Abstract

Penicillin, the first of the beta-lactam antibiotics, was introduced into medical practice in the 1940s. Since then, a large number of different beta-lactams, including penicillins, cephalosporins, monobactams, and carbapenems, have been developed, all of which are structurally related through the presence of a core beta-lactam ring. Resistance to beta-lactam antibiotics among target pathogens developed early in the history of their use. Of the mechanisms of resistance, the most widespread and most important is the destruction of the beta-lactam ring, which is mediated by beta-lactamases. The fact that these resistance enzymes may be coded on plasmids means that they are mobile within a bacterial community, and that they have spread widely. Resistance to beta-lactams mediated by beta-lactamases can be overcome successfully with the use of beta-lactamase inhibitors. The combination of beta-lactams with beta-lactamase inhibitors restores the activity of the beta-lactams, allowing their continued clinical use. The development of beta-lactamase inhibitors allows clinicians to rely on the well-tolerated, clinically effective beta-lactam antibiotics to treat a variety of bacterial infections.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / pharmacology*
  • Anti-Bacterial Agents / therapeutic use
  • Drug Resistance, Microbial
  • Enzyme Inhibitors / pharmacology*
  • beta-Lactamase Inhibitors
  • beta-Lactamases / biosynthesis
  • beta-Lactamases / metabolism*
  • beta-Lactams

Substances

  • Anti-Bacterial Agents
  • Enzyme Inhibitors
  • beta-Lactamase Inhibitors
  • beta-Lactams
  • beta-Lactamases