Lactamase Inhibitor Combinations

Several formulations combine a p-lactam antibiotic with a p-lactamase inhibitor (ampicillin-sulbactam [Unasyn], ticarcillin-clavulanic acid [Timentin], piper-acillin-tazobactam [Zosyn], and amoxicillin-clavulanic acid [Augmentin]). All of the p-lactamase inhibitor combinations except amoxicillin-clavulanic acid are parenteral formulations. Amoxicillin-clavulanic acid is the only combination drug with oral bioavailability. Elimination of the combination drugs occurs primarily by renal excretion. Therefore, all of the p-lactamase inhibitor combinations require dose adjustments in patients with renal insufficiency. The addition of the p-lactamase inhibitor significantly broadens the spectrum of antibacterial activity against p-lactamase-producing organisms. Consequently, these drugs have clinical use in treating infections with known or suspected mixed bacterial flora, such as biliary infections, diabetic foot ulcers, endomyometritis, and peritonitis.

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