期刊
JOURNAL OF MEDICAL MICROBIOLOGY
卷 70, 期 12, 页码 -出版社
MICROBIOLOGY SOC
DOI: 10.1099/jmm.0.001462
关键词
antimicrobial resistance; beta-lactams; last resort
类别
资金
- Wellcome Trust Doctoral Training Programme in Antimicrobials and Antimicrobial Resistance funding [108876/Z/15/Z]
Carbapenems are powerful antibiotics that inhibit bacterial cell-wall biosynthesis and are highly effective against both Gram-negative and Gram-positive drug-resistant infections. However, side effects such as nausea, vomiting, and seizures can occur in some recipients. Clinical resistance is primarily driven by enzymatic hydrolysis of the beta-lactam ring, classified into Class A, B, and D enzymes.
Carbapenems are potent members of the beta-lactam family that inhibit bacterial cell-wall biosynthesis inhibitors. They are highly effective against Gram-negative and Gram-positive drug-resistant infections. As such, carbapenems are typically reserved as an antibiotic of last resort. The WHO lists meropenem as an essential medicine. Nausea and vomiting are reported in <= 20% of carbapenem recipients, with 1.5% suffering seizures. Enzymatic hydrolysis of the beta-lactam ring is the main driver of clinical resistance. These enzymes can be classified as Class A, B and D. Classes A and D are serine beta-lactamases, whereas Class B rely on metal-mediated hydrolysis, typically through zinc.
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