Role of β-Lactamases in the Resistance of Gram-Negative Bacilli to β-Lactam Antibiotics

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Abstract
Few studies in animal models or humans have been performed to prove that the mechanism of resistance to β-lactam antibiotics in the presence of β-lactamases is similar in vivo and in vitro. In vivo, it seems likely that different parameters will influence each other: the penetration of the antibiotic into the site of infection; the stability of the drug; and the organism responsible for the infection, which affects the type and amount of 13-lactamase released into the environment. In vitro, the different enzymatic parameters responsible for the inactivation of various compounds have been well defined. However, overall resistance to 13-lactams in the presence of 13-lactamase may also be influenced by the function of the outer membrane in gram-negative bacteria.

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