A Practical Look at the Clinical Usefulness of the Beta-Lactam/Beta-Lactamase Inhibitor Combinations

Hart, Susan M.; Bailey, E.

doi:10.1177/106002809603001013

Cited by 14 publications

(6 citation statements)

References 63 publications

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“…Thus piperacillin/tazobactam is highly appropriate for the treatment of nosocomial pneumonia [13]. Escherichia coli, Proteus mirabilis, Klebsiella pneumoniae and staphylococci (excluding methicillin-resistant strains) are highly susceptible to piperacillin/tazobactam [14,15].…”

Section: Introductionmentioning

confidence: 99%

Piperacillin/Tazobactam vs Imipenem/Cilastatin in the Treatment of Nosocomial Pneumonia—a Double Blind Prospective Multicentre Study

Schmitt

Leitner²,

Welte

et al. 2006

Infection

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Section: Introductionmentioning

confidence: 99%

Piperacillin/Tazobactam vs Imipenem/Cilastatin in the Treatment of Nosocomial Pneumonia—a Double Blind Prospective Multicentre Study

Schmitt

Leitner²,

Welte

et al. 2006

Infection

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“…Amoxycillin/clavulanic acid (A/C) is a broad‐spectrum antibiotic prescribed for various infections such as tonsillitis, pneumonia, otitis, sinusitis and urinary tract infection [1, 2]. Clavulanic acid is a β‐lactamase inhibitor produced by Streptomyces clavuligerus [3].…”

Section: Introductionmentioning

confidence: 99%

First‐trimester exposure to amoxycillin/clavulanic acid: a prospective, controlled study

Berkovitch

Diav–Citrin

Greenberg

et al. 2004

Brit J Clinical Pharma

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AimsThe number of published studies on the use of amoxycillin/clavulanic acid during pregnancy is small and so is the number of pregnancies investigated in those studies. In this study we wished to investigate prospectively the safety of intrauterine exposure to amoxycillin/clavulanic acid in a relatively large cohort of women. MethodsWomen treated ( n = 191) with amoxycillin/clavulanic acid during the first trimester of pregnancy were recruited from two teratogen information centres in Israel. Exposed women were matched for age, smoking habits and alcohol consumption with 191 controls exposed to amoxycillin only for similar medical indications. ResultsMaternal age, birth weight, gestational age at delivery, rates of live births and abortions were comparable between the two groups. Rates of major malformations in the amoxycillin/clavulanic acid group (3/158, 1.9%) did not differ significantly from controls (5/163, 3%) ( P = 0.49, relative risk = 0.62, 95% confidence interval 0.15, 2.55), and were within the expected baseline risk for the general population. ConclusionThese data suggest that exposure to amoxycillin/clavulanic acid during pregnancy is unlikely to be associated with an increased risk of malformations.

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“…All three inactivators are used clinically in combination with antibiotics to treat intra-abdominal infections, skin and soft tissue infections, and upper and lower respiratory tract infections (9,12,20). Different combinations of antibiotics and inactivators are used: ticarcillin with clavulanate, amoxicillin with clavulanate, piperacillin with tazobactam, and ampicillin with sulbactam.…”

mentioning

confidence: 99%

“…Different combinations of antibiotics and inactivators are used: ticarcillin with clavulanate, amoxicillin with clavulanate, piperacillin with tazobactam, and ampicillin with sulbactam. These combinations are used to treat infections caused by bacteria producing enzymes in group 2, including Pseudomonas aeruginosa, Serratia marcescens, E. coli, and others (5,6,10,12,20,30). The model enzyme used in the study described here is PSE-4, a plasmid-derived ␤-lactamase from gram-negative bacteria.…”

mentioning

confidence: 99%

Characterization of a PSE-4 Mutant with Different Properties in Relation to Penicillanic Acid Sulfones: Importance of Residues 216 to 218 in Class A β-Lactamases

Sabbagh¹,

Thériault²,

Sanschagrin³

et al. 1998

Antimicrob Agents Chemother

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Class A β-lactamases are inactivated by the suicide inactivators sulbactam, clavulanic acid, and tazobactam. An examination of multiple alignments indicated that amino acids 216 to 218 differed among class A enzymes. By random replacement mutagenesis of codons 216 to 218 in PSE-4, a complete library consisting of 40,864 mutants was created. The library of mutants with mutations at positions 216 to 218 in PSE-4 was screened on carbenicillin and ampicillin with the inactivator sulbactam; a collection of 14 mutants was selected, and their bla genes were completely sequenced. Purified wild-type and mutant PSE-4 β-lactamases were used to measure kinetic parameters. One enzyme, V216S:T217A:G218R, was examined for its peculiar pattern of inhibition. There was an increase in theKm from 68 μM for the wild type to 271 μM for the mutant for carbenicillin and 33 to 216 μM for ampicillin. Relative to the wild-type PSE-4 enzyme, 37- and 30-fold increases inKi values were observed for the mutant enzyme for sulbactam and tazobactam, respectively. The results that were obtained suggested that positions 216 to 218 are important for interactions with penicillanic acid sulfone inhibitors. In contrast, V216 and A217 in the TEM-1 class A β-lactamase do not tolerate amino acid residue substitutions. However, for the PSE-4 β-lactamase, 11 of 14 mutants from the library of mutants with mutations at positions 216 to 218 whose sequences were determined had substitutions at position 216 (G, R, A, S) and position 217 (A, S). The data showed the importance of residues 216 to 218 in their atomic interactions with inactivators in the PSE-4 β-lactamase structure.

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A Practical Look at the Clinical Usefulness of the Beta-Lactam/Beta-Lactamase Inhibitor Combinations

Cited by 14 publications

References 63 publications

Piperacillin/Tazobactam vs Imipenem/Cilastatin in the Treatment of Nosocomial Pneumonia—a Double Blind Prospective Multicentre Study

Piperacillin/Tazobactam vs Imipenem/Cilastatin in the Treatment of Nosocomial Pneumonia—a Double Blind Prospective Multicentre Study

First‐trimester exposure to amoxycillin/clavulanic acid: a prospective, controlled study

Characterization of a PSE-4 Mutant with Different Properties in Relation to Penicillanic Acid Sulfones: Importance of Residues 216 to 218 in Class A β-Lactamases

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