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The hydrolysis of benzylpenicillin is catalysed by alkoxide ions and other oxygen bases. Catalysis occurs by a nucleophilic pathway and the intermediate ester can be detected in some cases. The Brsnsted Pnuc for alkoxide ions is 0.97, and is compatible with rate-limiting ring opening of the plactam. A solvent isotope effect of 3.2 for the trifluoroethanol-catalysed reaction suggests protonation by water occurs to the departing p-lactam nitrogen. Penicillin is not a particularly effective acylating agent of alcohols.

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Key Points Question What individual and residential characteristics are associated with COVID-19 outcomes for people with intellectual and developmental disabilities receiving residential services? Findings In this cohort study of 543 adults with intellectual and developmental disabilities receiving residential services in New York City, age, larger residential settings, Down syndrome, and chronic kidney disease were associated with COVID-19 diagnosis. Heart disease was associated with COVID-19 mortality. Meaning This study’s findings suggest that risk factors for COVID-19 diagnosis and mortality for people with intellectual and developmental disabilities receiving residential services are similar to (age, preexisting conditions, size of residence) and unique from (Down syndrome) those reported in the general population.