Factors that affect the in-vitro activity of cephalosporin antibiotics

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Abstract
The factors that affect the ability of β-lactam antibiotics to inhibit Gram-positive species are: the ability of the agents to bind to receptor proteins involved in cell wall synthesis called PBPs, their ability to withstand attack by β-lactamases which are exoenzymes, and their ability to activate hydrolytic enzymes in the cell. In the case of Gram-negative bacteria, both aerobic and anaerobic, ability to pass through the outer wall permeability area, resistance to plasmid and chromosomal β-lactamases located in the periplasm of the cell, as well as the affinity of binding to PBPs are the critical factors in the activity of a β-lactam compound. The amount of β-lactamases produced, the inducibility of β-lactamases, the ability of certain β-lactams to inhibit β-lactamases as well as the ability of the β-lactamase to hydrolyse the β-lactam will explain differences in the in-vitro activity of the third-generation cephalosporins. Ceftizoxime, an aminothiazolyl-methoxyimino cephalosporin, has the structural properties that have caused it to retain most of the Gram-positive activity while markedly increasing the activity against common and less common enteric bacteria resistant to older penicillins and cephalosporins.

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