Meeting the challenges of -lactamases

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Abstract
A wide variety of β -lactamases are found in clinical isolates of bacteria and, when present, these enzymes often result in resistance to one or more β -lactam antibiotics. The prevalence of organisms with these enzymes has increased as β -lactams have been increasingly used in clinical practice. This paper defines the nature of these enzymes and details the attempts to overcome the problem of resistance mediated by β -lactamase, efforts which have culminated in the development of a series of effective β -lactamase inhibitors which can be combined with β -lactam antibiotics. The currently available compounds, clavulanic acid, sulbactam, and tazobactam are very effective inhibitors of many types of β -lactamases, but there are additional enzymes which are resistant even to these inhibitors and which pose continuing challenges for the pharmaceutical chemist and clinician alike.

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