Updated: 7/23/2017

Penicillinase-Resistant Penicillins

Topic
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Introduction
  • Classification
    • antibiotic
      • penicillin-family (β-lactam)
        • penicillin
          • penicillinase-resistant penicillins
  • Drugs
    • methicillin (IV)
    • nafcillin (IV)
    • oxacillin (IV)
    • cloxacillin (oral)
    • dicloxacillin (oral)
Mechanism
  • Action
    • see Penicillin 
    • larger R group confers penicillinase resistance
  • Resistance
    • MRSA is resistant to entire class due to altered penicillin-binding protein (PBP)
      • reduced affinity for antibiotic
    • resistant to all beta-lactam antibiotics, including cephalosporins and carbapenems
Uses
  • S. aureus
    • used with strains of S. aureus that produce penicillinase
    • cannot be used with methicillin-resistant S. aureus (MRSA)
Adverse effects
  • Interstitial nephritis (methicillin)
    • has led to ↓ clinical use of methicillin
  • Allergy
 

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