infectious diseases
Beta Lactams
Beta Lactamase Inhibitors
Beta-lactamase inhibitors are drugs that block the activity of certain beta-lactamases and are thus sometimes combined with beta-lactam antibiotics. Examples include Clavulanate, sulbactam, tazobactam: These drugs block penicillinases but not AmpC or carbapenemases. They also block some ESBLsin vitro, but most combinations that include these drugs are not reliable against ESBL producers clinically. Sulbactam also has antibacterial activity against a limited number of bacterial species, includingNeisseria gonorrhoeae,Bacteroides fragilis, and, most importantly,A. baumanii(a bacterium with the potential for substantial antimicrobial resistance). Avibactam: This drug blocks class A (ESBLs, most KPCs), class C (AmpC), and some class D (OXA), but not class B (MBLs) beta-lactamases. Relebactam and vaborbactam: These drugs block classes A and C but not classes D and B. There are no currently available beta-lactamase inhibitors active against MBLs, such as NDM-1 (New Delhi MBL-1), VIMs (Verona integron–encoded MBLs), and IMP (imipenem)-types, which can inactivate all beta-lactam antibiotics except for Monobactams . However, many strains that produce MBLs also produce other beta-lactamases that can hydrolyze 