Parenteral beta-lactamase inhibitor combinations for clinical use.

Abstract

Beta-lactamase enzymes are commonly produced by staphylococci, the Enterobacteriaceae, Pseudomonas aeruginosa and certain anaerobic organisms, such as Bacteroides fragilis. The production of beta lactamases is an important mechanism through which bacteria become resistant to antibiotics. The currently marketed beta-lactamase inhibitor combinations include ampicillin-sulbactam, ticarcillin-clavulanate potassium and, more recently, piperacillin-tazobactam. These extended spectrum antibiotic combinations share the ability to inhibit methicillin-susceptible staphylococci, nearly all anaerobic bacteria and many Enterobacteriaceae. Ticarcillin-clavulanate potassium and piperacillin-tazobactam also have activity against P. aeruginosa. The combination agents are useful in the treatment of moderate to severe infections, particularly when a polymicrobial etiology is suspected or documented.