Beta-lactamase inhibitors
Inactivating bacterial beta-lactamases so the partner penicillin survives.
Also called β-lactamase inhibitors.
Class card
- Drugs
- Clavulanic acid and Tazobactam
- Used for
- Chest infections, including pneumonia
- Skin and soft tissue infections, including bites
- Urinary tract infections
- Intra-abdominal infections
- Known for
- Cholestatic jaundice (co-amoxiclav)
- Allergic reactions, including anaphylaxis
- Name stems
- -bactam
3 cards: the class, and each drug in it.
Mechanism of action
How do beta-lactamase inhibitors work?
Beta-lactamase inhibitors are beta-lactams with almost no useful antibacterial action of their own. They bind at or near the active site of bacterial beta-lactamases and inactivate them, so a partner penicillin given with them is not broken down. Clavulanic acid and tazobactam block mainly class A enzymes; class B, C and D beta-lactamases escape clavulanic acid.
The drugs
Beta-lactamase inhibitors with a card
- Clavulanic acidThis card covers clavulanic acid as the beta-lactamase inhibitor partner in co-amoxiclav (amoxicillin/clavulanic acid). On its own it has no clinically useful antibacterial effect.
- TazobactamThis card covers tazobactam as the beta-lactamase inhibitor partner in piperacillin/tazobactam; it is never given alone.
Uses
What are beta-lactamase inhibitors used for?
- Chest infections, including pneumonia
- Skin and soft tissue infections, including bites
- Urinary tract infections
- Intra-abdominal infections
- Sinusitis
- Middle ear infections (otitis media)
Side effects
Side effects of beta-lactamase inhibitors
- Cholestatic jaundice (co-amoxiclav)Known forSerious
- Allergic reactions, including anaphylaxisKnown forSerious
- Diarrhea
- Nausea and vomiting
- HepatitisSerious
- Rash
- C. difficile colitisSerious
- Severe skin reactions (SJS, TEN, DRESS)Serious
- Oral or vaginal thrush
- Acute kidney injury (piperacillin/tazobactam)Serious
What the class has in common. Each drug's card has its own, and Known for marks what an exam expects you to know.
Watch for
Cautions
- They are given only with a penicillin, so a penicillin allergy rules the combination out.
- Past jaundice or liver damage with co-amoxiclav is a contraindication; liver function is watched in liver disease.
- If the bacterium is susceptible to the penicillin alone, the combination is not used.
Remember them
A way to remember them
A bodyguard for the penicillin: the inhibitor takes the beta-lactamase's hit so the penicillin survives to kill.
Clavulanic acid and tazobactam are beta-lactams that tie up beta-lactamase at its active site. They do almost nothing to bacteria on their own; their job is to keep amoxicillin or piperacillin intact.
Written for biofideX
Name stems
-bactam means beta-lactamase inhibitor
Tazobactam, sulbactam and relebactam protect a partner beta-lactam from bacterial enzymes. Clavulanic acid works the same way without the stem.
- Every drug name stem
Don't mix them up
Classes easily confused with these
Sources
Checked against
Written for biofideX in plain words, after checking these references:
- Beta-lactamase Inhibitor (NCI Thesaurus)
- Clavulanic Acid (NCI Thesaurus)
- Tazobactam (NCI Thesaurus)
- Amoxicillin and clavulanate potassium tablets: label (DailyMed)
- Piperacillin and tazobactam for injection: label (DailyMed)
- Co-amoxiclav 500 mg/125 mg film-coated tablets: SmPC (emc)
- Co-amoxiclav (NHS)
For learning pharmacology, not for treatment decisions: no doses are given, and a prescriber, pharmacist or the product's own label is the word on any one patient. Spotted a mistake? Tell us and we'll correct it.
Antibiotics: the cell wall
Practice beta-lactamase inhibitors with the other classes in this group: what each drug is, how it works, what it treats and what it's known for.
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