An update on β-lactamase inhibitor discovery and development

Drug Resist Updat. 2018 Jan:36:13-29. doi: 10.1016/j.drup.2017.11.002. Epub 2017 Nov 7.

Abstract

Antibiotic resistance, and the emergence of pan-resistant clinical isolates, seriously threatens our capability to treat bacterial diseases, including potentially deadly hospital-acquired infections. This growing issue certainly requires multiple adequate responses, including the improvement of both diagnosis methods and use of antibacterial agents, and obviously the development of novel antibacterial drugs, especially active against Gram-negative pathogens, which represent an urgent medical need. Considering the clinical relevance of both β-lactam antibiotics and β-lactamase-mediated resistance, the discovery and development of combinations including a β-lactamase inhibitor seems to be particularly attractive, despite being extremely challenging due to the enormous diversity, both structurally and mechanistically, of the potential β-lactamase targets. This review will cover the evolution of currently available β-lactamase inhibitors along with the most recent research leading to new β-lactamase inhibitors of potential clinical interest or already in the stage of clinical development.

Keywords: Antibiotic resistance; Beta-lactamase; Crystal structure; Drug discovery; Inhibitor.

Publication types

  • Review

MeSH terms

  • Bacterial Proteins / antagonists & inhibitors*
  • Bacterial Proteins / chemistry
  • Bacterial Proteins / metabolism
  • Drug Combinations
  • Drug Design
  • Drug Discovery*
  • Gram-Negative Bacteria / drug effects
  • Gram-Negative Bacteria / physiology*
  • Gram-Negative Bacterial Infections / drug therapy*
  • Gram-Negative Bacterial Infections / microbiology
  • Molecular Structure
  • Structure-Activity Relationship
  • beta-Lactam Resistance / drug effects
  • beta-Lactam Resistance / physiology
  • beta-Lactamase Inhibitors / chemistry
  • beta-Lactamase Inhibitors / pharmacology*
  • beta-Lactamase Inhibitors / therapeutic use
  • beta-Lactamases / chemistry
  • beta-Lactamases / metabolism

Substances

  • Bacterial Proteins
  • Drug Combinations
  • beta-Lactamase Inhibitors
  • beta-Lactamases