[Beta-lactamase inhibitors].
BETA-LACTAMASE: The capacity to produce beta-lactamase, an enzyme which hydrolyses penicillin and cephalosporines, is the main source of bacterial resistance to beta-lactamines, thus the important contribution of beta-lactamase inhibitors (clavanulanic acid, sulbactam and tazobactam).


RESULTS
Beta-lactamase inhibitors inactivate these enzymes and, in association with beta-lactamines, offer wide spectrum bactericidal action (Gram negative bacilli, anaerobic germs, methicillin-sensitive staphylococci and streptococci) and can be used as first-line treatment in certain community-acquired and nosocomial infections.


RESULTS
Widespread use of these inhibitors selects intermediate or resistant strains. Toxicity is low. Undesirable effects (poor digestive tolerance for oral formulations) are dose-dependent. RIGOROUS PRESCRIPTION: Recent development of bacterial resistance emphasizes the importance of rational use of these associations and the need for a better definition of the optimal doses. Prescriptions must avoid underdosing and excessively long treatments. Treatment should be simplified if sensitivity to an antibiotic with a narrower spectrum is recognized.
Launay
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O
Service de Médicine interne, Hôpital Bichat-Claude Bernard, Paris.
Joly-Guillou
M L
ML
Decré
D
D
Crémieux
A C
AC
D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D001424:Bacterial Infections / Q000188:drug therapy; D004359:Drug Therapy, Combination / Q000494:pharmacology / Q000627:therapeutic use; D004791:Enzyme Inhibitors / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D065093:beta-Lactamase Inhibitors; D047090:beta-Lactams
D000900:Anti-Bacterial Agents; D004791:Enzyme Inhibitors; D065093:beta-Lactamase Inhibitors; D047090:beta-Lactams