Other ? - lactam antibiotic

Other ? - lactam antibiotic
A-Carbapenems
*Imipenem
-Imipenem combined with cilastatin to prevent metabolism by renal dehydropeptidase
-against ?-lactamases MO , G+,- , anaerobes , P. au
Uses: septicaemia
abdominal infection
pneumonia

*Meropenem & doripenem
-similar but not metabolized by kidney enzymes
-pass CSF

*ertapenem
lacks coverage against P. aeruginosa, Enterococcus species

B-Monobactams
*Aztreonam
-against G- & aerobic, but not G+& anaerobes


C-?-lactamase inhibitor
Clavulanic acid, salbactam, tazobactam
- Contain ?-lactam ring but don’t have sig antimicrobial activity
- Act after combination, protect Pen from ?-lactamase
Other cell wall synthesis inhibitor:
Vancomycin (Time dependent Bactericidal)
- MRSA, G+ Staph, Clostridia, enterococci
-inhibit transglycosylation step

Uses:
-with Cefotaxim & Ceftriaxone for meningitis
-with aminoglycoside for enterococcal endocarditis
-Orally for enterocolitis (Closteridium)

Fosfomycin
-blocks cell wall synthesis
-indicated for urinary tract infections
(Polymyxins (detergent-like effect
-bind to phospholipids of cell mm of G -
*polymyxinB
*colistin (polymyxin E)