β-Lactam/β-Lactamase Inhibitor Combinations: Role in the Antimicrobial Therapy

Clinical Microbiology and Antimicrobial Chemotherapy. 2005; 7(4):393-402

​ Ortenberg E.A., Ushakova M.A., Veshkurtseva I.M., Rojaev M.V.
antimicrobial resistance β-lactamases clavulanate sulbactam tazobactam
Section
Antimicrobials
Type
Journal article
Publication
Clinical Microbiology and Antimicrobial Chemotherapy. 2005; 7(4):393-402

Abstract

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.

  • 1. Kuijper E.J., Schippers E.F., Bernards A.T. Linezolid, an agent from a new class of antibiotics. Ned Tijdschr Geneeskd 2004; 148:1577-81.
  • 2. Ныс П.С., Курочкина В.Б., Скляренко А.В., Вейнберг П.А. Бета-лактамные соединения. Взаимосвязь структуры и биологической активности. Антибиотики и химиотер 2000; 45, 11:36-42.
  • 3. Jasovich A., Soutric J., Morera G., et al. Efficacy of amoxicillin-sulbactam, given twice-a-day, for the treatment of community-acquired pneumonia: a clinical trial based on a pharmacodynamic model. J Chemother 2002; 14:6:591-6.
  • 4. Casellas J.M., Israele V., Marin M., et al. Amoxicillin-sulbactam versus amoxicillin-clavulanic acid for the treatment of non-recurrent-acute otitis media in Argentinean children. Int J Pediatr Otorhinolaryngol 2005; 69:1225-33.
  • 5. Lovera D, Arbo A. Treatment of childhood complicated community-acquired pneumonia with amoxicillin/ sulbactam. J Chemother 2005; 17:283-8.
  • 6. Bantar C., Nicola F., Arenoso H., et al. An ex-vivo pharmacodynamic study comparing bactericidal activity of amoxicillin/sulbactam, azithromycin, doxycycline and levofloxacin against Streptococcus pneumoniae. J Chemother 2004; 16:248-54.
  • 7. Acuna C., Rabasseda X. Amoxicillin-sulbactam: A clinical and therapeutic review. Drugs Today 2001; 37:193-210.
  • 8. Urban C., Go E., Mariano N., et al. Effect of sulbactam on infections caused by imipenem-resistant Acinetobacter calcoaceticus biotype anitratus. J Infect Dis 1993; 167:448-51.
  • 9. Koeth L.M., Good C.E., Appelbaum P.C., Goldstein E. J., et al. Surveillance of susceptibility patterns in 1297 European and US anaerobic and capnophilic isolates to co-amoxiclav and five other antimicrobial agents. J Antimicrob Chemother 2004; 53:1039-44.
  • 10. Livermore D.M. β-Lactamase mediated resistance and opportunities for its control. J Antimicrob Chemother 1998; 41(Suppl. D):28-41.
  • 11. Эйдельштейн М.В. β-Лактамазы аэробных грамотрицательных бактерий: характеристика, основные принципы классификации, современные методы выявления и типирования. Клин микробиол антимикроб химиотер 2001; 3:223-42.
  • 12. Bush K., Jacobi G.A, Mederios A.A. A functional classification scheme for β-lactamases and its correlation with molecular structure. Antimicrob Agents Chemother 1995; 39:1211-33.
  • 13. Cидоренко С.В. Бета-лактамазы расширенного спектра: клиническое значение и методы детекции. Инфекции и антимикроб тер 2002; 6:8-12.
  • 14. Березин А.Г., Ромашов А.М., Яковлев С.В., Сидоренко С.В. Характеристика и клиническое значение бета-лактамаз расширенного спектра. Антибиотики и химиотер 2003; 48:5-11.
  • 15. Kaye K.S., Gold H.S., Schwaber M.J., et al. Variety of beta-lactamases produced by amoxicillin-clavulanate-resi stant Escherichia coli isolated in the north-eastern United States. Antimicrob Agents Chemother 2004; 48:1520-5.
  • 16. Bonfiglio G., Livermore DM. Beheviour of β-lactamase-positive and –negative Staphylococcus aureus isolates in susceptibility tests with piperacillin/ tazobactam and other beta-lactam/beta-lactamase inhibitor combinations. J Antimicrob Chemother 1993, 32:431-44.
  • 17. Fasola E.L., Fasching C.E., Peterson L.R. Molecular correlation between in vitro and in vivo activity of beta-lactam and beta-lactamase inhibitor combinations against methicillin-resistant Staphylococcus aureus. J Lab Clin Med 1995; 125:200-11.
  • 18. Livermore D.M., Seetulsingh P. Susceptibility of Escherichia coli isolates with TEM-1 β-lactamase to combinations of BRL 42715, tazobactam or clavulanate with piperacillin or amoxicillin. J Antimicrob Chemother 1991; 27:761-7.
  • 19. Lister P.D. Beta-lactamase inhibitor combinations with extended-spectrum penicillins: factors influencing antibacterial activity against Enterobacteriaceae and Pseudomonas aeruginosa. Pharmacother 2000; 20:213S-218S.
  • 20. Страчунский Л.С., Галкин Д.В., Козлов Р.С. и др. Эффективность цефоперазона/сульбактама при бактериальном сепсисе: результаты многоцентрового проспективного исследования «ИРИС». Клин микробиол антимикроб химиотер 2003; 5:318-28.
  • 21. Livermore D.M. Determinants of the activity of β-lactamase inhibitor combinations. J Antimicrob Chemother 1993; 31(Suppl. A):9-21.
  • 22. Практическое руководство по антиинфекционной химиотерапии. Под ред. Л.С. Страчунского, Ю.Б. Белоусова, С.Н. Козлова. М.: Боргес, 2002. c. 47-56.
  • 23. Venditti M., Cassone M., Falcone M., Pavoni G., et al. Piperacillin-tazobactam in the treatment of severe nosocomial infections. Recenti Prog Med 2002; 93:200-11.
  • 24. Kanra G. Experience with ampicillin/sulbactam in severe infections. J Int Med Res 2002; 30(Suppl. 1):20A-30A.
  • 25. Blahova J., Kralikova K., Krcmery V. Sr., Vaculikova A., et al. First occurrence of transferable extended-spectrum beta-lactamase hydrolyzing cefoperazone in multiresistant nosocomial strains of Klebsiella pneumoniae from two hospitals in Czech and Slovak Republics. J Chemother 2002; 14:461-4.
  • 26. White A.R., Kaye C., Poupard J., Pypstra R., et al. Augmentin (amoxicillin/clavulanate) in the treatment of community-acquired respiratory tract infection: a review of the continuing development of an innovative antimicrobial agent. J Antimicrob Chemother 2004; 53(Suppl. 1):S3-S20.
  • 27. Яковлев В.П., Щавелев Д.Л., Яковлев С.В. Клинико- лабораторное обоснование назначения цефоперазона/сульбактама больным с тяжелыми госпитальными инфекциями. Инфекции и антимикробная терапия 2002; 5:132-8.
  • 28. File T.M. Jr., Benninger M.S., Jacobs M.R. Evolution of amoxicillin/clavulanate in the treatment of adults with acute bacterial rhinosinusitis and community-acquired pneumonia in response to antimicrobial-resistance patterns. Clin Lab Med 2004; 24:531-51.
  • 29. Lode H. Community-acquired lower respiratory tract infections: clinical experience with beta-lactam/ beta-lactamase inhibitors. Int J Clin Pract 2002; 125:10-17.
  • 30. Namyslowski G., Misiolek M., Czecior E., Malafiej E., et al. Comparison of the efficacy and tolerability of amoxycillin/clavulanic acid 875 mg b.i.d. with cefuroxime 500 mg b.i.d. in the treatment of chronic and acute exacerbation of chronic sinusitis in adults. J Chemother 2002; 14:508-17.
  • 31. Чучалин А.Г., Синопальников А.И., Яковлев С.В., Страчунский Л.С. и др. Внебольничная пневмония у взрослых: практические рекомендации по диагностике, лечению и профилактике. Пособие для врачей. Смоленск: 2003. 53 с.
  • 32. Klein J.O. Amoxicillin/clavulanate for infections in infants and children: past, present and future. Pediatr Infect Dis J 2003; 22(Suppl. 8):S139-S148.
  • 33. Benninger M.S. Amoxicillin/clavulanate potassium extended release tablets: a new antimicrobial for the treatment of acute bacterial sinusitis and community-acquired pneumonia. Expert Opin Pharmacother 2003; 4:1839-46.
  • 34. File T.M. Jr., Lode H., Kurz H., Kozak R., et al. Double-blind, randomized study of the efficacy and safety of oral pharmacokinetically enhanced amoxicillin-clavulanate (2,000/125 milligrams) versus those of amoxicillin-clavulanate (875/125 milligrams), both given twice daily for 7 days, in treatment of bacterial community-acquired pneumonia in adults. Antimicrob Agents Chemother 2004; 48:3323-31.
  • 35. Sethi S., Breton J., Wynne B. Efficacy and safety of pharmacokinetically enhanced amoxicillin-clavulanate at 2,000/125 milligrams twice daily for 5 days versus amoxicillin-clavulanate at 875/125 milligrams twice daily for 7 days in the treatment of acute exacerbations of chronic bronchitis. Antimicrob Agents Chemother 2005; 49:153-60.
  • 36. Gresser U. Amoxicillin-clavulanic acid therapy may be associated with severe side effects – review of the literature. Eur J Med Res 2001; 6:139-49.
  • 37. Kenyon S., Boulvain M., Neilson J. Antibiotics for preterm rupture of the membranes: a systematic review. Obstet Gynecol 2004; 104:1051-7.
  • 38. Lewis D.F., Adair C.D., Robichaux A.G., Jaekle R.K., et al. Antibiotic therapy in preterm premature rupture of membranes: Are seven days necessary? A preliminary, randomized clinical trial. Am J Obstet Gynecol 2003; 188:1413-6.
  • 39. Allewelt M., Schuler P., Bolcskei P.L., Mauch H., et al. Ampicillin+sulbactam vs clindamycin+/–cephalosporin for the treatment of aspiration pneumonia and primary lung abscess. Clin Microbiol Infect 2004; 10:163-70.
  • 40. Acquarolo A., Urli T., Perone G., Giannotti C., et al. Antibiotic prophylaxis of early onset pneumonia in critically ill comatose patients. A randomized study. Intensive Care Med 2005; 31:510-6.
  • 41. Wood G.C., Hanes S.D., Croce M.A., Fabian T.C., et al. Comparison of ampicillin-sulbactam and imipenem-cilastatin for the treatment of Acinetobacter ventilator-associated pneumonia. Clin Infect Dis 2002; 34:1425-30.
  • 42. Levin A.S., Levy C.E., Manrique A.E., Medeiros E.A. Severe nosocomial infections with imipenem-resistant Acinetobacter baumannii treated with ampicillin/ sulbactam. Int J Antimicrob Agents 2003; 21:58-62.
  • 43. Tatman-Otkun M., Gurcan S., Ozer B., Shokrylanbaran N. Annual trends in antibiotic resistance of nosocomial Acinetobacter baumannii strains and the effect of synergistic antibiotic combinations. New Microbiol 2004; 27:21-8.
  • 44. Smolyakov R., Borer A., Riesenberg K., Schlaeffer F., et al. Nosocomial multi-drug resistant Acinetobacter baumannii bloodstream infection: risk factors and outcome with ampicillin-sulbactam treatment. J Hosp Infect 2003; 54:32-8.
  • 45. Dajani A. Use of ampicillin/sulbactam and sultamicillin in pediatric infections: a re-evaluation. J Int Med Res 2001; 29:257-69.
  • 46. Pape L., Gunzer F., Ziesing S., Pape A., et al. Bacterial pathogens, resistance patterns and treatment options in community acquired pediatric urinary tract infection. Klin Padiatr 2004; 216:83-6.
  • 47. Периоперативная антибиотикопрофилактика в абдоминальной хирургии. Под ред Федорова В.Д., Плешкова В.Г., Страчунского Л.С. Клин микробиол антимикроб химиотер 2004; 6:186-92.
  • 48. Ise Y., Hagiwara K., Saitoh S., Honjo K., et al. Comparison of the effects of prophylactic antibiotic therapy and cost-effectiveness between cefazolin (CEZ) and Sulbactam/Ampicillin (SBT/ABPC) in gastric cancer surgery employing clinical pathway. Yakugaku Zasshi 2004; 124:815-24.
  • 49. Holzheimer R.G., Dralle H. Antibiotic therapy in intra-abdominal infections - a review on randomised clinical trials. Eur J Med Res 2001; 6:277-91.
  • 50. Genne D., Menetrey A., Jaquet A., Indino P., et al. Treatment of secondary peritonitis: is a less expensive broad-spectrum antibiotic as effective as a carbapenem? Dig Surg 2003; 20:415-20.
  • 51. Щукина Н.А., Буянова С.Н, Федорович О.К., Аполихина И.А и др. Эффективность и безопасность Амоксиклава + Рокситромицин (ЛЕК) при лечении пациенток с воспалительными заболеваниями органов малого таза. РМЖ 2003; 27:1534-37.
  • 52. Wawruch M., Bozekova L., Krcmery S., Kozlikova K., et al. Cost-effectiveness analysis of switching from intravenous to oral administration of antibiotics in elderly patients. Bratisl Lek Listy 2004; 105:374-8.
  • 53. Cometta A., Kern W. International antimicrobial therapy cooperative group de l’EORTC. Treatment with oral antibiotics of febrile neutropenia in onco-haematology. The experience of the EORTC antimicrobial group. Presse Med 2004; 33:327-9.
  • 54. Lipsky B.A., Itani K., Norden C. Linezolid Diabetic Foot Infections Study Group. Treating foot infections in diabetic patients: a randomized, multicenter, open-label trial of linezolid versus ampicillin-sulbactam/ amoxicillin-clavulanate. Clin Infect Dis 2004; 38:17-24.
  • 55. Hooton T.M., Scholes D., Gupta K., Stapleton A.E., et al. Amoxicillin-clavulanate vs ciprofloxacin for the treatment of uncomplicated cystitis in women: a randomized trial. JAMA 2005; 293:949-55.
  • 56. Антибактериальная терапия инфекций мочевыводящих путей у беременных (пособие для врачей). Клин микробиол антимикроб химиотер 2004; 6:218-23.
  • 57. Erasmo A.A., Crisostomo A.C., Yan L.N., Hong Y.S., et al. Randomized comparison of piperacillin/tazobactam versus imipenem/cilastatin in the treatment of patients with intra-abdominal infection. Asian J Surg 2004; 27:227-35.
  • 58. Rodrigo J.P., Surez C., Bernaldez R., Collado D. Efficacy of piperacillin-tazobactam in the treatment of surgical wound infection after clean-contaminated head and neck oncologic surgery. Head Neck 2004; 26:823-8.
  • 59. Bassotti G., Chistolini F., Sietchiping-Nzepa F., De-Roberto G., et al. Empirical antibiotic treatment with piperacillin-tazobactam in patients with microbiolo gically-documented biliary tract infections. World J Gastroenterol 2004; 10:2281-3.
  • 60. Figuera A., Rivero N., Pajuelo F., Font P., et al. Comparative study of piperacillin/tazobactam versus imipenem/ cilastatin in febrile neutropenia (1994-1996). Med Clin 2001; 116:610-1.
  • 61. Решедько Г.К. Микробиологические основы клинического применения аминогликозидов в стационарах России. Автореф. дисс. докт. мед. наук. Смоленск: 2004. 53 с.
  • 62. Бодман К.Ф., Лоренц Дж., Бауэр Т.Т., Эвиг С. и др. Нозокомиальная пневмония: профилактика, диагностика, лечение. Клин микробиол антимикроб химиотер 2004; 6:92-102.
  • 63. Berger A., Kretzer V., Apfalter P., Rohrmeister K., et al. Safety evaluation of piperacillin/tazobactam in very low birth weight infants. J Chemother 2004; 16:166-71.
  • 64. Casellas J.M., Tome G., Bantar C., Bertolini P., et al. Argentinean collaborative multicenter study on the in vitro comparative activity of piperacillin-tazobactam against selected bacterial isolates recovered from hospitalized patients. Diagn Microbiol Infect Dis 2003; 47:527-37.
  • 65. Spanu T., Luzzaro F., Perilli M., Amicosante G., et al. Occurrence of extended-spectrum β-lactamases in members of the family Enterobacteriaceae in Italy: implications for resistance to β-lactams and other antimicrobial drugs. Antimicrob Agents Chemotherapy 2002; 46:196-202.
  • 66. Rhomberg P.R., Jones R.N., Sader H.S.; MYSTIC Programme (US) Study Group. Results from the Meropenem Yearly Susceptibility Test Information Collection (MYSTIC) Programme: report of the 2001 data from 15 United States medical centres. Int J Antimicrob Agents 2004; 23:52-9.
  • 67. Pfaller M.A., Jones R.N., MYSTIC Study Group (Europe). Antimicrobial susceptibility of inducible AmpC beta-lactamase-producing Enterobacteriaceae from the Meropenem Yearly Susceptibility Test Information Collection (MYSTIC) Programme, Europe 1997-2000. Int J Antimicrob Agents 2002; 19:383-8.
  • 68. Solomkin J., Teppler H., Graham D.R., Gesser R.M., et al. Treatment of polymicrobial infections: post hoc analysis of three trials comparing ertapenem and piperacillin-tazobactam. Antimicrob Chemother 2004; 53(Suppl. 2):S51-S57.
  • 69. Jones R.N., Salazar J.C., Pfaller M.A., Doern G.V. Multicenter evaluation of antimicrobial resistance to six broad-spectrum beta-lactams in Colombia using the E-test method. The Colombian Antimicrobial Resistance Study Group. Diagn Microbiol Infect Dis 1997; 29:265-72.
  • 70. Lim V.K., Halijah M.Y. In vitro activity of sulperazon against recent isolates of ceftazidime-resistant bacteria. Med J Malaysia 2001; 56:365-9.
  • 71. Fu W., Demei Z., Shi W., Fupin H., Yingyuan Z. The susceptibility of non-fermentative Gram-negative bacilli to cefoperazone and sulbactam compared with other antibacterial agents. Int J Antimicrob Agents 2003; 22:444-8.
  • 72. Ozyilkan O., Yalcintas U., Baskan S. Imipenem-cilastatin versus sulbactam-cefoperazone plus amikacin in the initial treatment of febrile neutropenic cancer patients. Korean J Intern Med 1999; 14:15-9.
  • 73. Winston D.J., Bartoni K., Bruckner D.A., Schiller G.J., et al. Randomized comparison of sulbactam/cefoperazone with imipenem as empirical monotherapy for febrile granulocytopenic patients. Clin Infect Dis 1998; 26:576-83.
  • 74. Bodey G., Abi-Said D., Rolston K., Raad I., et al. Imipenem or cefoperazone-sulbactam combined with vancomycin for therapy of presumed or proven infection in neutropenic cancer patients. Eur J Clin Microbiol Infect Dis 1996; 15:625-34.
  • 75. Madan A.K. Use of ciprofloxacin in the treatment of hospitalized patients with intra-abdominal infections. Clin Ther 2004; 26:1564-77.
  • 76. Li J., Zhu Y., Hu W. A randomized clinical study of sulperazone versus tienam in the treatment of LRTIs. Zhonghua Nei Ke Za Zhi 1996; 35:819-23.
  • 77. Овсянкин А.В., Муконин А.А. Клинико-бактериологическое обоснование использования цефоперазона/сульбактама в комплексном лечении больных с гнойно-деструктивными заболеваниями легких. Антибиотики и химиотер 2003; 49:25-9.
  • 78. Namiduru M., Gungor G., Karaoglan I., Dikensoy O. Antibiotic resistance of bacterial ventilator-associated pneumonia in surgical intensive care units. J Int Med Res 2004; 32:78-83.
  • 79. Бекетов А.С., Сидоренко С.В., Писарев В.В., Комаров М.М. Сравнительная клинико-экономическая оценка бета-лактамных антибиотиков при лечении интраабдоминальных инфекций. Антибиотики и химиотер 2003; 48:34-41.
  • 80. Uchiyama K., Kawai M., Onishi H., Tani M., et al. Preoperative antimicrobial administration for prevention of postoperative infection in patients with laparoscopic cholecystectomy. Dig Dis Sci 2003; 48:1955-9.
  • 81. Gendel I., Azzam Z.S., Braun E., Levy Y., et al. Antibiotic utilization prevalence: prospective comparison between two medical departments in a tertiary care university hospital. Pharmacoepidemiol Drug Saf 2004; 13:735-9.
  • 82. Вешкурцева И.М., Ортенберг Э.А., Ушакова М.А. Возможности коррекции потребления аминогликозидов (АГ) в отделениях детского стационара. Клин микробиол антимикроб химиотер 2005; 7(Прил. 1):18.
  • 83. Ушакова М.А., Ортенберг Э.А., Вешкурцева И.М., Мухачева С.Ю. Влияние адекватной антибактериальной терапии на течение и исход сепсиса у пациентов ОРИТ. Клин микробиол антимикроб химиотер 2005; 7(Прил. 1):54-5.
Views
0 Abstract
0 PDF
0 Crossref citations
Shared