Antibiotic Inhibitors of Bacterial Cell Wall Biosynthesis

Antibiotic Inhibitors of Bacterial Cell Wall Biosynthesis - D.J. Tipper

This chapter describes the large family of antimicrobial agents that act on bacterial cell walls. These include some of the most commonly used antibiotics in many health-care settings (amoxicillin and ampicillin). At the heart of penicillins and cephalosporins is a β‎-lactam ring structure, which imparts much of the antibacterial activity. This strength is also a weakness, as bacterial enzymes (β‎-lactamases) can destroy the ring structure. Combinations of penicillin derivatives and β‎-lactamase inhibitors (e.g. clavulanic acid and tazobactam) have been designed to overcome this weakness. Cephalosporins also contain β‎-lactam rings but tend to be more resistant to attack by β‎-lactamases, although more recently extended spectrum β‎-lactamases produced by some Gram-negative bacilli have rendered even the latest versions inactive. Finally, the glycopeptides (e.g. vancomycin and teicoplanin) have a different mode of action on the cell wall and came to prominence as the main choice to treat methicillin-resistant Staphylococcus aureus (MRSA) infections.