4 member ring with 3C and 1N

carbonyl alpha to N

Bind with PBPs and disrupts cell wall synthesis

stops development of peptidoglycan structure, so only works on growing bacteria with peptidoglycan cell walls

1. alterations to PBPs

2. B-lactamase production

3. decreased permeability

4. efflux pumps

Gram negative have a membrane over peptidoglycan layer, gram positive do not.

So beta lactams can disrupt peptidoglycan synthesis better in gram positives since there is no physical protective barrier

decrease resistance to beta lactams in bacteria that produce beta lactamase

by deactivating the enzyme

clavulanic acid

sulbactam

tazobactam

Beta lactamase inhibitors improve coverage against___

(3)

1. staph

2. anaerobe

3. gram negatives that produce beta lactamase

Natural pencillins

spectrum of activity

Gram + - strep but not staph (since the beta lactamase)

Gram -   - neisseria

syphilis

Antistaphylococcal penicillins

(3)

and spectrum of activity

Naf, oxa, diclocillin

works only on gram positives

staph (not MRSA) and strep

gram positives only

strep and staph (not MRSA)

amoxicilin+clavulenic acid, ampicillin+sulbactam

Range of activity

gram positive- strep, enterococci and staph

gram negative- better than penicillins, but still limited

Anaerobes- yes

carbenicillin, timentin

range of activity

strep, staph (with b lactamase inhibitor)

better gram negative than aminopencillins, broader enteric gram negative rods (with b lactamase inhib)

anaerobes with b lact inhib

Zosyn

(piperacillin with tazobactam)

strep, stap

broad gram negative including pseudmonas

anaerobes

Penicillin

Abosorption

penicilin, dicloxacillin and ampicillin on empy stomach

amoxicillin can be taken with food

Penicillins 

Distribution

Pencillins

Metabolism

Pencillins

ADRs