Dual beta-lactam treatment: Pros and cons

Abstract

The battle against microscopic pathogens has always baffled the scientific community. Nowadays, multidrug-resistant microorganisms lead to high in-hospital mortality, increased hospital stays, and high health-related costs. Treating infections due to these high-resistance pathogens with a low number of antibiotic molecules creates the need for new strategies. Although some already think of a "postantibiotic era" with bacteriophages as the main futuristic weapon in antibacterial armament, others rethink the usage of the already existent drugs. Dual beta-lactam therapy has been used for quite some time as an empirical therapy for some severe infections such as endocarditis or meningitis. However, studies regarding the use of a beta-lactam combination stopped being made a long time ago, and it seems the scientific community has no interest in evaluating this as a treatment option. Could this strategy be applied to treat infections due to multidrug-resistant bacteria? Could this be the answer while waiting for the "postantibiotic era"? What kind of pathogens could we fight using dual beta-lactams? What are the downsides of this strategy? These are some of the questions the authors try to answer in this review. In addition, we try to convince our peers to turn once more into researching beta-lactam combinations and exploring its potential benefits.

The Impact of Enterococcus spp. in the Immunocompromised Host: A Comprehensive Review

“…Although Enterococcus intrinsic cephalosporins resistance, the association with ampicillin leads to penicillin-binding proteins (PBPs) inactivation, justifying the success of the combination. Specifically, several endocarditis episodes showed a reduced vegetation after this therapeutic regimen [189].…”

Kualitas Penggunaan Antibiotik pada Pasien Community-Acquired Pneumonia di Salah Satu Rumah Sakit di Bali

“…Kombinasi dua β-Lactam memberikan efek sinergis melalui inantivasi beberapa tipe PBPs sehingga dapat mengeradikasi bakteri dan meminimalkan terjadinya resistensi bakteri terhadap antibiotik β-Lactam. 21,22 Meskipun demikian, kombinasi dual β-Lactam masih perlu dikaji lebih lanjut mengingat adanya antibiotik β-Lactam generasi lebih baru yang memiliki spectrum yang sangat luas seperti golongan carbapenem. Pada penggunaan antibiotik β-Lactam generasi baru dengan spektrum yang sangat luas, kombinasi dual β-Lactam tidak memberikan keuntungan dalam perluasan spectrum.…”