Publication

Abstract : Penicillin, the first β - lactam antibiotic was introduced into clinical practice in 1940s. Since then a large number of different β - l actam antibiotics including penicillins, cephalosporins, monobactam and carbapenems have been de veloped. All of them are structurally related through the presence of a core β - lac tam ring. β - lacta m antibiotics interfere with the synthesis of bacterial cell wall , they also inhibit the transpeptidases so t hat cross linking does not take place. The wide use of β - lactam antibiotics has created major resistance problems leading to increased morbidity, mortality and heath care costs. Resi stance is most often mediated by lactamases which is produced from both gram negative and positive bacteria. β - lactamases are enzymes responsible for many failures of antimicrobial therapy because of the hydrolysis of β - lactam antibiotics to inert and ineffective agents. β - lactamases are one of the reason behind the bacterial resistance to β - lactam antibiotics . In recent yea rs new varieties of beta lactamases has b een detected in increasing rate . Combination of β - lactam antibiotics with β - lactamases inhibitors has been successfully used to control resistance during last two decades. These inhibitors greatly en hance the effica cy of their partner β - lactam antibiotics (amoxillin, ampicillin, piperacillin, and ticarcillin) in the treatment of serious Entero bacteriaceae and penicillin resistant Staphylococcal infections. The prevalence of clinically relevant β - lactamases from othe r classes that are resistant to inhibition is rapidly increasing. Lack of effectiveness of currently available β - lactamase inhibitors is a main problem with the combination therapy. This review describes the various β - lactum antibiotics and effect of diffe rent β – lactamases that produced by the sever al bacteria ’ s against the β - lacta m antibiotics, their resistance pattern and its effective management with combination therapy .