Clinical Microbiology and Antimicrobial Chemotherapy. 2005; 7(4):393-402
At present, β-lactams are the most commonly used antimicrobials, but their clinical efficacy may be reduced because of the spread of antimicrobial resistance. The most important mechanism of resistance to β-lactams is an inhibition by the microbial enzymes – β-lactamases. In order to overcome this resistance mechanism, βlactam/β-lactamase inhibitor combinations have been developed. This paper reviews the mechanism of action and properties of currently available β-lactamase inhibitors. Spectrum of antimicrobial activity and scope of the use of β-lactam/β-lactamase inhibitor combinations are described in detail. Results of the comparative clinical trials of those combinations published during the past 5 years are also presented. Along with the data supporting clinical efficacy of β-lactam/β-lactamase inhibitor combinations in the treatment of various infections both in adults and children, safety data and possible limitations are discussed.