AMOXYCILLIN

Close congener of ampicillin, similar to it in all aspects except:
Oral absorption is better, food does not interfere with absorption
Incidence of diarrhea is less
Less active against H.influenzae & Shigella
CARBOXYPENICILLINS
Carbenicillin: special feature is its activity against Pseudomonas aeruginosa & indole positive proteus which are not inhibited by PnG
PK: niether acid resistant nor penicillinase resistant, inactive orally, given by im or iv route
Use : serious infections caused by pseudomonas or proteus e.g. burn, UTI, septicemia etc
ANTIPSEUDOMONAS PENICILLINS
Carbenicillin
Ticarcillin
Piperacillin
Mezlocillin
BETA LACTAMASES INHIBITOR
Beta lactamase are family of enzymes, produced by many gram positive & negative bacteria that inactivate beta lactam antibiotic
Clavulanic acid: obtained from S. clavuligerus
It has a beta lactam ring but no antibacterial activity of its own
It inhibits a wide variety of beta lactamases
Progressive inhibitor of beta lactamases
Suicide inhibitor
It inhibits the periplasmically located Beta Lactamases enzyme in gram –ve bacteria
PK: rapid oral absorption, it is used with amoxycillin (coamoxyclav),
Uses: addition of clavulanic acid reestablishes the activity of amoxycillin against PP S. aureus but not MRSA that have altered PBP
Skin & soft tissue infections
Gonorrhea:(PPNG) Single dose amoxycillin 3g +clavulanic acid 0.5g + probenecid 1g is highly active
Sulbactam: semisynthetic beta lactamase inhibitor
Related chemically as well as in activity to clavulanic acid
Also a progressive inhibitor of beta lactamases
Less potent than clavulanic acid
Sulbactam does not induce chromosomal beta lactamases while clavulanic acid can induce some of them
Sulbactam is given parenterally
It is combined with ampicillin ( sultamicillin tosylate)
Uses: PPNG gonorrhoea
Mixed aerobic anaerobic infections
ADR: thrombophlibitis of injected vein, rashes, diarrhoea etc
TAZOBACTAM
Beta lactamase inhibitor, which is similar to sulbactam
Combined with piperacillin
Use : severe infections like peritonitis, pelvic & respiratory infections produced by beta lactamase producing bacilli