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- W1562826972 abstract "Resistance to β lactam antibiotics is an increasing problem worldwide. This review describes the classification and mechanism of action of βlactamases and the options available for detecting, treating, and controlling extended spectrum β lactamasesβlactam antimicrobial agents are the most common treatment for bacterial infections (table 1).1 Rates of bacterial resistance to antimicrobial agents are increasing worldwide, including in Lebanon.2 Production of β lactamases is the most common mechanism of bacterial resistance (table 2).1 3 These enzymes are numerous, and they mutate continuously in response to the heavy pressure of antibiotic use, leading to the development of extended spectrum β lactamases (ESBLs).4 Examples are the mutated TEM and SHV genes, mainly found in strains of Escherichia coli and Klebsiella pneumoniae respectively. Infections with ESBL producing bacterial strains are encountered singly or in outbreaks, especially in critical care units in hospitals, resulting in increasing costs of treatment and prolonged hospital stays. We aim to present a simplified review of this highly complex subject, in the hope that it will guide the practising physician in appropriate decisions relating to the use of β lactams in patient care.View this table:Table 1 Groups and examples of β lactam antimicrobial agentsView this table:Table 2 Antimicrobial agents, their modes of action, and the corresponding mechanisms of bacterial resistanceWe examined new information from the most recent relevant literature retrieved from PubMed and the internet.The β lactams are a family of antimicrobial agents consisting of four major groups: penicillins, cephalosporins, monobactams, and carbapenems (table 1). They all have a β lactam ring, which can be hydrolysed by β lactamases. The groups differ from each other by additional rings (thiazolidine ring for penicillins, cephem nucleus for cephalosporins, none for monobactams, double ring structure for carbapenems). The various antibiotics in each group differ by the nature of one …" @default.
- W1562826972 created "2016-06-24" @default.
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- W1562826972 date "2003-11-22" @default.
- W1562826972 modified "2023-09-25" @default.
- W1562826972 title "Recent developments in lactamases and extended spectrum lactamases" @default.
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- W1562826972 doi "https://doi.org/10.1136/bmj.327.7425.1209" @default.
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