Beta lactamase inhibitors

Pediatric Resident
MGMCRI
Pondicherry

1. BETA- LACTAMase INHIBITORS Dr Ravi Kumar s Pediatric resident MGMCRI

2. BETA-LACTAM Antibiotics which contain beta lactam rings in their molecular structures are : Penicillin Cephalosporins Monobactum Carbapenem

3. MOA It i nterfere s with bacterial cell wall synthesis It inhibits the transpeptidases so that cross linking does not take place Cross linkages between peptide chains of the neighbouring strands provides stability and rigidity to the cell wall.

4. BETA-LACTAM inhibitors β- lactamases are a family of enzymes produced by many gram-positive and gram-negative bacteria that inactivate β- lactam antibiotics by opening the β- lactam ring. Different β- lactamases differ in their substrate affinities. Three inhibitors of this enzyme are C lavulanic acid, S ulbactam and T azobactam are available for clinical use.

5. CLAVULANIC ACID Has a rapid oral absorption Addition of clavulanic acid re-establishes the activity of amoxicillin against β- lactamase producing resistant Staph. aureus (but not MRSA), H. influenzae , N. gonorrhoeae , E. coli, Proteus, Klebsiella , Salmonella and Shigella. Indicated for Respiratory tract, Skin & Soft tissue, intra abdominal infections . Dosage : 100mg/kg/day in 4 divided doses

6. SULBACTUM 2–3 times less potent than clavulanic acid Oral absorption of sulbactam is inconsistent. Therefore, it is preferably given parenterally It has been combined with ampicillin for use against β- lactamase producing resistant strains Used commonly in Surgical Infections & Gonorrhea . Dosage Ampicillin with Sulbactum : 200mg/kg/day in 4 divided doses

7. TAZOBACTUM It is si milar to sulbactam . Its pharmacokinetics matches with piperacillin with which it has been combined for use in severe infections like peritonitis, pelvic/urinary/respiratory infections caused by β- lactamase producing bacilli . Dosage : Piperacillin+Tazobactum : 200-300mg/kg/day in 3 divided doses

8. tHANKYOU