Beta-lactam antibiotics

General information

The largest group of antibiotics are the so-called beta-lactam antibiotics. These include the probably best known antibiotic penicillin as well as the group of cephalosporins (e.g. cefuroxime) and carbapenems (e.g. imipenem).

Effect

All beta-lactam antibiotics have a germicidal effect on especially fast-growing bacteria. They are mainly given in cases of coccal infestation (pneumococcus in pneumonia, streptococci in angina and erysipelas, gonococcus in syphilis and meningococcus in meningitis). A distinction is also made between penicillin G and penicillin V. There are penicillins that are not resistant to betalactamase (penicillin) and those that are resistant to betalactamase.

These include the staphylococcal penicillin Flucloxacillin, which is often given for Staphylococcus aureus infections. The antibiotics that are not resistant to betalactamase are often administered in combination with betalactamase inhibitors in order to achieve an effect despite betalactamse. Non-betalactamase-resistant antibiotics are often administered in combination with betalactamase inhibitors in order to still guarantee an effect.

The aminopenicillins (ampicillin, amoxicillin) are often administered for coccus infections of the lungs and the ear, nose and throat tract. A special indication is the urinary tract infection during pregnancy. In addition, this group of substances is given prophylactically to patients at risk of developing inflammation of the inner wall of the heart (e.g. during dental or jaw surgery).

In 5-10% of the cases, patients develop skin reactions (exanthema) under the treatment of the preparation or as a complication a so-called pseudomembranous colitis. Patients who already have skin reactions for other reasons should not be given these preparations. As ampicillin is difficult to absorb in the intestine, the main forms of administration are in liquid intravenous form. The acylaminopenicillins (mezlocillin, piperacillin) are given for severe infections.

Side effect

As a side effect of the beta-lactam antibiotics can: result in. Should this side effect occur, the therapy should be continued without fail, but additional antipyretic medication should be given, bed rest should be prescribed and the medication should be given slowly. – Allergies

  • Damage to the nerves (neurotoxicity) and
  • An increased release of killed bacteria with accompanying chills and fever (Jarisch-Herxheimer reaction

Interaction

Penicillin should not be combined with cephalosporins, as this can lead to a so-called cross-reaction. Bacteria are able to form an enzyme (beta-lactamase) in places, which attacks the beta-lactam structure of the antibiotic and thus makes it ineffective.