3,5,16] Colistin is usually combined with sulbactam, cephalosporins, carbapenems, piperacillin-tazobactam, monobactams
, aminoglycosides, fluoroquinolones, rifampin, tetracyclines and tigecycline.
Like most carbapenemases, KPCs are enzymes which inactivate all beta-lactam antibiotics, including carbapenems, penicillins, cephalosporins and monobactams
Other [beta]-lactam antibiotics: [beta]-Lactamase inhibitors, carbapenems, and monobactams
ESBL enzymes initially come up through point mutations in the genes encoding the classic TEM and SHV [beta]-lactamase, resulting in one or more amino acids substitution near the active site of enzyme thus increasing their affinity and hydrolytic activity against third generation cephalosporins and monobactams
, and hence an array of oxyimino-[beta]-lactam hydrolyzing enzymes with wider spectrum of activity has been generated.
Options: aminocyclitols, aminoglycosides, carbapenems, cephalosporins, monobactams
, penicillins, cyclic lipopeptides, folate antagonists, fluoroquinolones, glycopeptides, immunomodulators, ketolides, lincosamides, macrocyclics, macrolides, mycobacterials, nitrofurans, oxazolidinones, peptides, pleuromutilins, polypeptides, pyridopyrimidines, quinolones, streptogramins, sulphonamides, tetracycline, other.
Likewise, the prevalence of infection by plasmid mediated ampC (pampC), which can hydrolyze penicillins, oxyimino-, 7-[alpha]-methoxycephalosporins and monobactams
, varies depending on the type of enzyme and geographical location and blaCMY-2 is the most frequently detected worldwide.
Vancomycin and the beta-lactam antibiotics (penicillins, cephalosporins, monobactams
and carbapenems) stop assembly of peptidoglycan in the bacterial cell wall (see figure 1).
Apart from [beta]-lactam susceptibility, the strains showed resistance to other classes of antimicrobial agents, such as fluoroquinolones, tetracyclines, and monobactams
The CTX-M-ases belong to the molecular class-A beta-lactamases, and the enzymes are functionally characterized as extended-spectrum beta-lactamases which confer resistance to penicillin, extended-spectrum cephalosporins, and monobactams
Beta-lactams are a broad group of antibiotics that include penicillins, cephalosporins, monobactams
For example, the recognized limitations of penicillin led to a wide array of penicillin analogs (ampicillin, phenoxymethylpenicillin, and so forth), and the more widely classified beta-lactam antibiotics (cephalosporin, monobactams
, carbapenems) that retained the active pharmacaphore while addressing difficulties in administration and bacterial resistance.
Carbapenems (imipenem) have a high degree of cross-reactivity with penicillin, but monobactams
(aztreonam) are generally tolerated.