Infectious Disease Pharmacology Series | Beta-Lactams Explained
Summary
TLDRThis educational YouTube video delves into the world of infectious disease pharmacology, focusing on beta-lactams and beta-lactamase producing bacteria. The presenter explains the function of beta-lactam antibiotics and how bacteria develop resistance through beta-lactamases. The video further discusses the role of beta-lactamase inhibitors in combating resistant bacteria, detailing various inhibitors and their combinations with antibiotics. The goal is to enhance understanding of antibiotic resistance and promote responsible antibiotic use for infection control.
Takeaways
- π Beta-lactams are a family of antibiotics that target the beta-lactam ring and disrupt the penicillin-bound proteins in bacteria, leading to their destruction.
- π¬ Beta-lactamase producing bacteria can create enzymes that break down antibiotics, rendering them ineffective against certain strains.
- π Examples of beta-lactamase producing bacteria include Pseudomonas, E. coli, Acetobacter, and Staphylococcus aureus, which can develop resistance to common antibiotics.
- π‘ Beta-lactamase inhibitors are compounds that counteract the enzymes produced by bacteria, protecting antibiotics from being broken down and enhancing their effectiveness.
- π‘ The combination of beta-lactam antibiotics with beta-lactamase inhibitors, such as tazobactam with piperacillin or amoxicillin with clavulanic acid, creates broader-spectrum antibiotics.
- π₯ Currently, there are six beta-lactamase inhibitors available in the U.S., each paired with specific antibiotics to target a range of resistant bacterial strains.
- π« Beta-lactamase inhibitors do not directly affect bacteria; they only work to enhance the efficacy of the accompanying antibiotic by inhibiting the bacterial enzymes.
- 𧬠Overuse or misuse of antibiotics can lead to increased bacterial resistance, which is a significant concern in modern medicine as it reduces the effectiveness of treatment options.
- π Understanding the mechanisms of antibiotic resistance and the role of beta-lactamase inhibitors is crucial for healthcare professionals to make informed decisions regarding antibiotic therapy.
- π The goal of infectious disease management is to control infections and practice antimicrobial stewardship, which includes using the right antibiotics for the shortest duration and based on bacterial susceptibilities.
Q & A
What are beta-lactams?
-Beta-lactams are a family of antibiotics that work by breaking open the beta-lactam ring and destroying the penicillin-bound protein of microorganisms on a cellular level. They include classes such as penicillins, cephalosporins, and carbapenems.
What is the role of beta-lactamase in bacteria?
-Beta-lactamase is an enzyme produced by certain bacteria that breaks down the beta-lactam ring in antibiotics, rendering them ineffective. This enzyme is responsible for antibiotic resistance in bacteria.
How do beta-lactamase inhibitors work?
-Beta-lactamase inhibitors work by inhibiting the bacterial beta-lactamases, preventing them from breaking down the beta-lactam antibiotics. This allows the antibiotics to remain active and effective against bacteria that would otherwise be resistant.
What is the difference between beta-lactam antibiotics and beta-lactamase inhibitors?
-Beta-lactam antibiotics are the actual drugs used to treat bacterial infections, while beta-lactamase inhibitors are compounds that protect these antibiotics from being broken down by bacterial enzymes, thus enhancing their effectiveness.
Which bacteria are known to produce beta-lactamases?
-Bacteria such as Pseudomonas, E. coli, Acetobacter, Staphylococcus aureus, and others can produce beta-lactamases, leading to antibiotic resistance.
What are some examples of beta-lactamase inhibitors available in the U.S.?
-In the U.S., examples of beta-lactamase inhibitors include tazobactam, clavulanic acid, sulbactam, and avibactam, which are used in combination with various beta-lactam antibiotics.
What is the purpose of combining beta-lactam antibiotics with beta-lactamase inhibitors?
-The purpose of combining beta-lactam antibiotics with beta-lactamase inhibitors is to broaden the spectrum of activity against bacteria that have developed resistance to the antibiotics alone, by protecting the antibiotics from enzymatic degradation.
How do beta-lactamase inhibitors help in treating resistant bacterial infections?
-Beta-lactamase inhibitors help in treating resistant bacterial infections by preventing the bacteria from breaking down the antibiotics, thus allowing the antibiotics to effectively kill the bacteria that would otherwise survive due to resistance.
Why is it important to practice antimicrobial stewardship when using antibiotics?
-Practicing antimicrobial stewardship is important to ensure the appropriate use of antibiotics, reduce the development of antibiotic resistance, and preserve the effectiveness of these drugs for future use.
What are some common names for antibiotics that include beta-lactamase inhibitors?
-Some common names for antibiotics that include beta-lactamase inhibitors are Zosyn (piperacillin-tazobactam), Augmentin (amoxicillin-clavulanate), and Unasyn (ampicillin-sulbactam).
Outlines
π Introduction to Beta Lactams and Beta-Lactamases
The speaker begins by welcoming viewers back to the channel and introduces the topic of infectious disease pharmacology, specifically focusing on antibiotics. They delve into the concept of beta lactams, a class of antibiotics that includes penicillins, cephalosporins, and carbapenems, which work by breaking the beta-lactam ring and disrupting the bacterial cell wall. The speaker emphasizes the importance of understanding medical terminology and provides an overview of how beta-lactam antibiotics target and destroy susceptible bacteria without causing significant harm to the host. The discussion then shifts to beta-lactamase producing bacteria, which can neutralize antibiotics by producing enzymes that break down the beta-lactam ring, rendering the antibiotics ineffective. Examples of such bacteria include Pseudomonas, E. coli, Acetobacter, and Staphylococcus aureus.
π‘ Beta-Lactamase Inhibitors: Combating Antibiotic Resistance
This section discusses the development of beta-lactamase inhibitors as a response to the growing issue of antibiotic resistance. Beta-lactamase inhibitors are compounds that can prevent bacteria from breaking down beta-lactam antibiotics, thus preserving their effectiveness. The speaker lists six beta-lactamase inhibitors available in the U.S., including tazobactam, clavulanate, and sulbactam, and explains their combinations with specific antibiotics such as piperacillin, amoxicillin, and ceftazidime. These combinations are designed to target a broad range of bacteria, including those that have developed resistance to standard antibiotics. The speaker also highlights the importance of using these inhibitors judiciously to prevent further resistance development.
π¬ Mechanism of Action and Clinical Application of Beta-Lactamase Inhibitors
The speaker elaborates on how beta-lactamase inhibitors work in conjunction with antibiotics to overcome bacterial resistance. They explain that these inhibitors do not directly affect the bacteria but rather protect the antibiotics from being degraded by bacterial enzymes. The discussion includes the clinical application of these inhibitors, emphasizing their use in treating infections caused by resistant bacteria. The speaker also touches on the importance of antimicrobial stewardship and the need for targeted therapy based on culture and susceptibility results to minimize resistance development. The segment concludes with a call for caution in antibiotic use and a reminder of the challenges faced in treating infections resistant to all forms of beta-lactamase inhibitors.
πΆ Conclusion and Final Thoughts
The video concludes with a brief musical interlude, signaling the end of the educational segment. The speaker expresses gratitude to the viewers and encourages them to continue learning and engaging with the content. The conclusion serves as a reminder of the importance of the topic discussed and the ongoing journey of understanding and combating antibiotic resistance.
Mindmap
Keywords
π‘Beta Lactam
π‘Beta-Lactamase
π‘Antibiotic Resistance
π‘Penicillin
π‘Cephalosporins
π‘Beta-Lactamase Inhibitors
π‘Tazobactam
π‘Clavulanic Acid
π‘Carbapenems
π‘Antimicrobial Stewardship
π‘Pseudomonas
Highlights
Introduction to beta-lactams and beta-lactamase producing bacteria in the context of infectious disease pharmacology.
Definition of beta-lactams as a family of drugs that disrupt the penicillin-bound protein in microorganisms.
Explanation of beta-lactam antibiotics including penicillins, cephalosporins, and carbapenems.
Illustration of how beta-lactam antibiotics work against susceptible organisms without causing harm to the host.
Discussion on beta-lactamase, an enzyme produced by bacteria that breaks down antibiotics.
Examples of bacteria that produce beta-lactamases, such as penicillinases and carbapenemases.
The role of beta-lactamase inhibitors in combating antibiotic resistance by inhibiting bacterial beta-lactamases.
Listing of six available beta-lactamase inhibitors in the U.S. market and their corresponding antibiotics.
Description of Tazobactam, a beta-lactamase inhibitor, and its combination with piperacillin to form Zosyn.
Explanation of how beta-lactamase inhibitors do not affect bacteria directly but enhance the effectiveness of antibiotics.
Identification of bacteria that are resistant to beta-lactamase inhibitors and the challenges in treating such infections.
Emphasis on the importance of antimicrobial stewardship and targeted therapy to limit antibiotic resistance.
The necessity of using the right susceptibilities and cultures to select appropriate antibiotics.
Highlighting the goal of infectious disease management: to eliminate bacteria as quickly as possible without overexposure.
A call to action for healthcare professionals to practice caution when dosing and selecting antibiotics.
Encouragement for viewers to continue learning and engaging with the channel for more educational content.
Transcripts
YouTube what's going on welcome back to
my channel uh this is a continuation
video of my previous video so you
haven't looked at that one already
please go look at that when they come
back to this one this is uh I'm
continuing on the Infectious Disease
pharmacology on antibiotics so
um we are diving deep into what is a
beta lactam and what is a beta-lactamase
producing bacteria so without further
Ado let's hop straight into the video
all right so first we need to understand
what is a beta lactam and what is a beta
lactamase okay I want you guys to
understand medical terminology so of
course I got my handy dandy uh notebook
or laptop or whatever you want to call
it so let's follow along so let's look
at this right here like I said before my
previous video a beta leg temp is a
family of drugs that breaks open the
beta Lake ring and destroys the
penicillin bounded protein of the uh
micro organisms on a cellular level so
beta-lactams consist of penicillins
cephalosporins carbon pendants among
back down it's a class of antibiotics
now let's look at this picture here
right you have the antibiotic which is
the beta lactam this is the beta lectem
antibiotic the beta lectem antibiotic
and now if we give it to susceptible
organisms so we we've we've got cultures
back uh we know exactly what we're
targeting so we give an antibiotic that
targets specifically this bacteria okay
we give this bacteria we give this
antibiotic to the bacteria and it should
destroy this bacteria
um relatively quickly and effectively
without doing causing too much harm
um to to the host right so we give the
antibiotic to the bacteria and it should
destroy it it should destroy this
bacteria
and then leaving the host which is the
human happy healed and whatever the case
may be in normal circumstances this is
what we want we want to Target the
bacteria as quickly and as efficient as
possible okay we want to get in and get
out don't over expose don't over chew
antibiotics because you're going to
cause some resistance so antibiotic
bacteria and we have a human that is
alive in it as well under normal
circumstances what we want now what is a
beta leg to maze okay
a beta-elect him 80s okay if a bacteria
produces anything with an ASE on the end
it creates a beta-lactum age which
breaks down the antibiotic that's
supposed to kill the bacteria okay uh
examples of this bacteria can create
penicillinases
beta-lactamases carpentameses if it ends
in 80s okay eggs A's a that means it
breaks down the corresponding drug class
okay it breaks down it destroys it
degrades it hydrolyzes okay it breaks
down the corresponding class of
antibiotics so penicillins penicillin
lasers so the age breakdown penicillin
the age breakdown of beta lactams the
A's break down the carb repentance okay
certain bacteria can produce these
um these beta-lactamases to break down
our antibiotics okay this bacteria has
created an AIDS specifically for
whatever antibiotic let's just say this
is a penicillin right let's just for the
for the sake of this video this is a
penicillin antibiotic this is a
penicillin antibiotic that's supposed to
kill
um the corresponding bacteria uh but now
this bacteria has created an A so a
penicillinase right so now that this
this bacteria has created an ace which
will break down this penicillin so in
normal circumstances we give the
penicillin antibiotic it's supposed to
kill the bacteria but now
this bacteria creates an ace that breaks
down the penicillin effectively
rendering in this penicillin useless
inactivating the penicillin now this
bacteria has gone and killed our patient
and this is not what we want the patient
is dead and
this is relatively common as far as
going way way back in the day when we
didn't really understand resistant
mechanisms and people will over treat or
treat for the wrong reasons bacteria
have developed resistance over the years
right certain bugs do create these ages
for certain bacterial classes this is
just a few of these bugs off the top of
my head that I know they create these uh
resistant patterns and this resistant
isolates against our classes of
antibiotics you have first and foremost
pseudomonas which is a gram negative
pseudomonas which is your Gram negative
which is your Gram the eclipse yellow
gram negative as well E coli gram
negative as well
acetobacter super resistant
gram negative as well acetobacter and
ground positive we have uh staph aureus
staff areas so staff Arias can create uh
it can be sensitive or it can be
resistant typically what we call Mercer
methicillin resistant staff ours or it
can be sensitive medicine and sensitive
staff artists right so this is what we
don't want so bacterial is like chest
right we give the antibiotic over time
um with wrong use wrong exposure the
bacteria has created a resistance
mechanism it created the A's so it
breaks down our antibiotics so they came
back with a chest move and now it's our
time to formulate something to come back
to break down that beta-lactam A's okay
so now as humans we created
what's called beta-lectum AIDS
Inhibitors okay
beta-lactinase Inhibitors they inhibit
the bacterial beta-lactum AIDS okay so I
told it's like chest baby that's why I
love bugs and drugs and infectious
disease so let's look at our
beta-lactamase Inhibitors right we have
currently on the market in the U.S in
the U.S I don't know what they do
overseas I don't know what they do in
Canada but in the U.S currently we have
six available beta-lactamase Inhibitors
on the market so Tazo back town okay
Tazo back time is is accompanied by two
antibiotics okay one of these
antibiotics is in the class of
penicillin and the other one is in the
class of cephalosporins right so
tazobactam is accompanied by
piperacillin
a paper ceiling and a class of
penicillin antibiotics
um together they form what's called
zosin
zosin
so they form zosin Piper cylinder back
down forms zosa it is the broadest
penicillin antibiotic that we have the
other one um that taste of bacterium is
accompanied with is in the third
generation selfless porn cephotolazane
taso back down
isn't it's actually a newer um
cephalosporin that came out relatively
like five six seven years ago
um so it's in uh what's classified as a
fifth generation simplest form of
septolazane tazobactin
cephalazine tazobactam
self told losing
Tazo Bechtel and together they formed
their backs up uh zerbexa so these are
the only two drugs
um there's a currently on the market
that accompanied by the beta-lactamase
inhibitor tazobacterium pepper cylinder
and self-tolezane tazobacterium in your
cephalosporin classes as far as so back
time is concerned we only really have
one um that is accompanied by Soul
bacterium that is ampicillin
it's still in your penicillin but your
Amino penicillins so ampicillin
ampicillin is the only one in the U.S
that has sold Back Time attached to it
ampicillin sulfactum creates Unison that
is the other drug name for unison
so it creates unison
in unison with each other so amperson
and Soul Back Down creates Unison
claudulaney again is in the penicillin
class but your immuno penicillin your
other Amino penicillin amoxicillin
okay amoxicillin
amox Sicilian
so amoxicillin is combined with cloudy
ulanate to form Augmentin I'm sure you
guys see that a lot outpatient when you
go pick it up Augmentin
so amoxicillin combined with clavulanic
acid to form Augmentin AV back Tim okay
this is one of those
in your third generation cephalosporin
ad bacterium is accompanied by your
third generation simplest form with
pseudomonal coverage
self-tazidine okay
self-tazidine self tazidine
ceftazidine self-tazidine 80 back time
okay this creates Abby cast okay you
might have heard Abby Cass Abby Cass
self-tasks AV back towns what we call it
self-task AV back down to create Abby
cast and really bectum is involved in
these last two are in your drugs of
carbo pendulums okay both of these are
accompanied by a carba Pinon so
really back down
really backed up is accompanied by any
panel okay Emmy Pim celastatin rally
back tab okay Emmy Penal
Emmy Penal
really backed no Emmy penal still is
dead I'm sorry
still a Statin
and then rally back towel okay really
back town
so this is a long it's it's it's a it's
a mouthful to say but Emmy Pim is a
Carver pedal um still a stand is just
there to prevent any panel from getting
broken down by the body not by bacteria
but by the body itself so Amy pill and
celistan will always be in combination
and then really back to him this is the
beta lactamase inhibitor that blocks all
of the bacteria from breaking down any
panel uh so Emmy Pelham siliston really
back Temp and last but certain lines is
Barbara back town varbo bactum is
accompanied by mirror penal okay mirror
pedal is very very commonly used in the
hospital mirror Penal
so Mirror film Barbara becktown creates
Vapor mirror it creates Vapor mirror
they bow bore mirror
it creates favorite meal okay these are
all of your beta-lactamase Inhibitors in
all of the the corresponding antibiotic
that goes along with okay you have Pepes
those what we call it piltazo we have
septalazine tazo-bactam ampicillin so
back down creates in unison amoxicillin
uh claudulent creates Augmentin um
ceftazidine AV backtown creates Abby
cast and then you have any pillum
Celestine really bectam
um and then you have mirror penal viral
bacterium creates Vapor view okay these
are your super super broad big guns when
things are super resistant so on most of
these
um Can combat these right here okay
these are your your extended Spectrum
beta-lactamase producing um bacteria
some of those so now let's look at this
let's look at back going back to um the
first point right we give an antibiotic
bacteria create the age to break down
our antibiotic right so now we can clap
back it's our chest move now we can clap
back now we have created beta-lactamase
Inhibitors right so we give this
antibiotic it's supposed to kill the
bacteria the bacteria think it's about
to kill our antibiotic but now we got a
beta-lactamase inhibitor to break down
and kill this and stop it right there
okay so now the beta lactam is
destroying the beta-lactamase so now in
vitro uh we're supposed to do what we
did on the first one right our
antibiotic is killing the bacteria which
yields a happy patient again and now we
are back on track right so now
another thing to note they do not have
effect on any type of bacteria so the
beta lactamase Inhibitors do not have
any type of effect on the actual
bacteria itself okay it's only there to
enhance the antibiotics I want to make
that very clear so you guys don't get no
type of confusion okay the beta
lactamase Inhibitors do not work on
bacteria themselves they only inhibit
the bacteria to increase the coverage
and effect of the actual antibiotic
um so your beta lactamase Inhibitors are
reserved for those super resistant
um
bacteria out there that creates those
um strains that produce beta-lectomase
penicillinases carbopendamases any type
of age that break down our antibiotics
okay and this was just a very brief
video on how beta lag tabs work how
beta-lactamase work and the whole point
of beta-lactamase Inhibitors and what
they do and everything is in between so
I hope people learn from this I hope you
guys learn from this uh this really will
enhance your knowledge or make you a
better pharmacist a better doctor a
better nurse practitioner whatever the
case may be or if you're just a nursing
you just want to know check your
knowledge this is exactly how it works
okay the goal of infectious disease is
infection control and antimicrobial
stewardship the goal of antibiotics is
to eliminate the bacteria for as short
as possible we want to get in get out we
don't want to overexpose because that
creates resistance we don't want to
wrongfully expose treat you need the
right susceptibilities you need the
right cultures Target therapy okay this
is what will limit our resistance like I
said you have some bugs out there that
is super super resistant and it's even
resistant to all of these beta lactamase
Inhibitors so if you have a bug that's
resistant to everything how are we going
to treat you how are we going to cure
the patient it's literally impossible
okay so we need to uh practice with
caution when we dosing antibiotics and
picking our antibiotics based on
cultures and sensitivities okay I really
hope you guys learn and follow along
this journey of mine with this YouTube
journey of mine I will be back with
several other videos Remember
I was born
[Music]
thank you
[Music]
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