1. Beta-lactam antibiotics
Pencillins
Cephalosporines
Carbapenems

2. Pencillin-History
1928- Alexander Fleming discovers a mold which inhibits the growth of staphylococcus bacteria
1940- penicillin is isolated and tested on mice by researchers at Oxford
1941- penicillin mass produced by fermentation for use by US soldiers in WWII
1950’s- 6-APA is discovered and semi-synthetic penicillins are developed.
1960’s -today- novel β-lactams/ β-lactamase inhibitors are discovered and modified from the natural products of bacteria

3. Pencillins &Cephalosporines
β-lactam ring

4. How do they work?
The β-lactam binds to Penicillin Binding Protein (PBP)
PBP is unable to crosslink peptidoglycan chains
The bacteria is unable to synthesize a stable cell wall
The bacteria is lysed

5. Pencillin –Classifiication
A.Natural penicillins
Pencillin G (Benzyl pencillin)
PencillinV (Phenoxy methyl pencillin)
Benzathine Pencillin,
Procaine Pencillin
B. Pencillinase resistant pencillin
Flucloxacillin, Cloxacillin
Methicillin,Temociilin etc.

6. Pencillin –Classifiication
C. Broad spectrum/extended spectrum pencillins.
Aminopencillins:- Amoxycillin,Ampicillin,Bacampicillin etc.
D. Antipseudomonal pencillins
Carbencillin,Ticarcillin, Piperacillin,etc.
E. Mecillinams
Pivemecillinam HCL

7. Beta-Lactamase inhibitors
Beta lactamase are a group of enzymes produced by many gram+ve,gram-ve bacteria that inactivate Beta-lactam antibiotics by opening the beta-lactam ring.
There are 3 types of Beta lactamase inhibitors
1.Clavulinic acid
2.Sulbactum
3.Tazobactum

8. Examples Amoxycillin+clavulinic acid:-
Augmentin,Co-amoxiclav,Enhancin,etc
Piperacillin + tazobactum:-
Tazocin, Zosyn etc
Ticarcillin+sulbactum:-
Timentin

9. Cephalosporines-Classification
1st Generation
Cefradine,Cephalexin, Cefazolin,Cefadroxil
2nd Generation
Cefoxitin, Cefuroxime, Cefaclor
3rd Generation
Cefotaxime, Ceftriaxone,Cefixime, Ceftazidime,Cefperazone,Cefpodoxime,Cefdinir
4th Generation
Cefepime,Cefpirome

10. Carbepenems& Monobactams
Drugs are
Imipenem
Meropenem
Doripenem
Ertapenem
Faropenem
Imipenem:- inactivated in the kidney by some enzymes; combination with Cilastatin a specific enzyme inhibitor to block renal metabolism.
Monobactam(monocyclic betalactam ring):- Aztreonam

11. Major adverse effects
Hypersensitivity reactions :- Rashes, itching,urticaria,angioedema,bronchospasm, anaphlyaxis/serum sickness, Jarisch –Herxheimer rection
Pain, Bleeding,Diarrhea,GI disturbances,Renal toxicity,neutropenia etc.

12. Thank u Philip k Mathew Clinical instructor School of Pharmacy
University of Nizwa