Infectious Disease Pharmacology Series | Beta-Lactams Explained

Summary

This 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

• 💊 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.
• 🔬 Beta-lactamase producing bacteria can create enzymes that break down antibiotics, rendering them ineffective against certain strains.
• 🌟 Examples of beta-lactamase producing bacteria include Pseudomonas, E. coli, Acetobacter, and Staphylococcus aureus, which can develop resistance to common antibiotics.
• 🛡 Beta-lactamase inhibitors are compounds that counteract the enzymes produced by bacteria, protecting antibiotics from being broken down and enhancing their effectiveness.
• 💡 The combination of beta-lactam antibiotics with beta-lactamase inhibitors, such as tazobactam with piperacillin or amoxicillin with clavulanic acid, creates broader-spectrum antibiotics.
• 🏥 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.
• 🚫 Beta-lactamase inhibitors do not directly affect bacteria; they only work to enhance the efficacy of the accompanying antibiotic by inhibiting the bacterial enzymes.
• 🧬 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.
• 📚 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.
• 🌐 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

00:00

💊 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.

05:01

🛡 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.

10:02

🔬 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.

15:03

🎶 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.

Keywords

💡Beta Lactam

Beta Lactam refers to a class of antibiotics that includes penicillins, cephalosporins, and carbapenems. They work by disrupting the bacterial cell wall synthesis, leading to the death of the bacteria. In the video, beta lactams are described as drugs that break open the beta lactam ring and destroy the penicillin-bound protein of microorganisms, thus functioning as a key mechanism for treating bacterial infections.

💡Beta-Lactamase

Beta-Lactamase is an enzyme produced by certain bacteria that can break down beta-lactam antibiotics, rendering them ineffective. This is a significant concern in antibiotic resistance, as the video explains, where bacteria develop mechanisms to counteract the effects of antibiotics, leading to treatment failure.

💡Antibiotic Resistance

Antibiotic Resistance is a phenomenon where bacteria evolve to withstand the effects of antibiotics, making infections harder to treat. The video discusses how improper use of antibiotics can lead to the development of resistant strains of bacteria that can defeat the intended antibiotic therapy.

💡Penicillin

Penicillin is a type of antibiotic derived from Penicillium fungi and is part of the beta-lactam class. It was one of the first antibiotics used to treat bacterial infections. The video uses penicillin as an example of a beta-lactam antibiotic that can be neutralized by beta-lactamase enzymes.

💡Cephalosporins

Cephalosporins are a group of antibiotics that are also part of the beta-lactam family. They are similar to penicillins but have a broader spectrum of activity against bacteria. The video mentions cephalosporins as one of the drug classes that can be accompanied by beta-lactamase inhibitors to enhance their effectiveness.

💡Beta-Lactamase Inhibitors

Beta-Lactamase Inhibitors are compounds that can prevent the action of beta-lactamase enzymes, thus protecting beta-lactam antibiotics from being broken down. The video explains that these inhibitors are used in combination with antibiotics to counteract resistant bacteria that produce beta-lactamases.

💡Tazobactam

Tazobactam is a specific beta-lactamase inhibitor that is often paired with penicillins and cephalosporins to enhance their effectiveness against bacteria that produce beta-lactamases. The video describes tazobactam as part of the combination that forms drugs like Zosyn and Zerbaxa.

💡Clavulanic Acid

Clavulanic Acid is another beta-lactamase inhibitor that is commonly combined with amoxicillin to create the antibiotic Augmentin. The video mentions Augmentin as an outpatient medication that combines amoxicillin and clavulanic acid to combat resistant bacteria.

💡Carbapenems

Carbapenems are a subgroup of beta-lactam antibiotics known for their broad-spectrum activity against many types of bacteria, including those resistant to other antibiotics. The video includes carbapenems as part of the discussion on beta-lactam antibiotics.

💡Antimicrobial Stewardship

Antimicrobial Stewardship refers to the careful use of antibiotics to preserve their effectiveness and prevent the development of resistance. The video emphasizes the importance of using the right antibiotics for the right duration and based on culture and sensitivity results to minimize resistance.

💡Pseudomonas

Pseudomonas is a genus of bacteria, some species of which are known to be highly resistant to many antibiotics, including beta-lactams. The video lists Pseudomonas as an example of a Gram-negative bacteria that can produce beta-lactamases, contributing to antibiotic resistance.

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

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thank you

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