Format

Send to

Choose Destination
J Pediatr Pharmacol Ther. 2011 Jan;16(1):23-30.

Beyond Susceptible and Resistant, Part I: Treatment of Infections Due to Gram-Negative Organisms With Inducible β-Lactamases.

Author information

1
Department of Clinical Pharmacy, University of California, San Francisco School of Pharmacy, San Francisco, California.

Abstract

Inactivation of β-lactams by the action of β-lactamase enzymes is the most common mode of resistance to these drugs among Gram-negative organisms. The genomes of some key clinical pathogens such as Enterobacter and Pseudomonas encode AmpC, an inducible chromosomal β-lactamase. The potent activity of AmpC against broad-spectrum β-lactams complicates treatment of organisms with this gene. Antibiotic exposure can select for mutants expressing high levels of this enzyme, leading to the emergence of resistant isolates and failure of therapy, even when the initial isolate is fully susceptible. The risk of selecting for resistant organisms varies according to the particular β-lactam used for treatment. This article reviews the microbiology of these enzymes, summarizes clinical data on the frequency emergence of resistance, and discusses considerations for antimicrobial treatment of these organisms.

PMID:
22477821
PMCID:
PMC3136230

Supplemental Content

Full text links

Icon for PubMed Central
Loading ...
Support Center