title: Combating bacterial resistance in skin and skin-structure infection: importance of beta-lactamase inhibition.
abstract: Serious skin and skin-structure infections may require parenteral antibiotic therapy. Such infections are generally polymicrobial, and they often involve both gram-positive and gram-negative aerobes as well as anaerobic bacteria. Effective treatment thus requires the use of a broad-spectrum antibiotic or combination therapy. The development of antibiotic resistance by clinically important pathogens has significantly increased the difficulty of treating skin and skin-structure infections. One of the major mechanisms of resistance observed in organisms likely to be associated with such infections is the development of beta-lactamases that inactivate beta-lactam antibiotics. Two approaches have been taken to combat this problem: the use of beta-lactam/beta-lactamase inhibitor combinations and the development of beta-lactamase-stable drugs. Both strategies have resulted in treatments that are clinically and bacteriologically effective in patients with skin and skin-structure infections. The use of one beta-lactam/beta-lactamase inhibitor combination, ampicillin/sulbactam, has been demonstrated to be more cost-effective than treatment with beta-lactamase-stable antibiotics, such as cefoxitin and imipenem/cilastatin, for this indication.
authors.affiliation: Department of Medicine, Mt. Sinai Medical Center, University of Miami School of Medicine, Florida, USA.
authors.forename: J C
authors.initials: JC
authors.lastname: Chan
mesh_terms: D000900:Anti-Bacterial Agents / Q000191:economics / Q000627:therapeutic use*; D004352:Drug Resistance, Microbial / Q000502:physiology*; D004359:Drug Therapy, Combination; D006801:Humans; D017192:Skin Diseases, Bacterial / Q000188:drug therapy*; D065093:beta-Lactamase Inhibitors; D047090:beta-Lactams
chemical_list: D000900:Anti-Bacterial Agents; D065093:beta-Lactamase Inhibitors; D047090:beta-Lactams