Inhibitors of Beta Lactamases
Avibactam
Sulbactam
Vaborbactam
Clavulanic Acid
Tazobactam

Inhibitors of Beta Lactamases

Various β-lactams bind to and inhibit the function of penicillin-binding proteins (PBPs). The PBP enzymes catalyze the final step in bacterial cell wall (peptidoglycan) synthesis. Learn more about β-lactams.

β-lactamases are genetically and structurally closely related to penicillin-binding proteins (Aronson, 2016). Therefore, bacteria that produce β-lactamases can bind to and destroy the β-lactams, and the penicillin-binding proteins can function uninhibited, leading to resistance. Learn more about β-lactamases.

Inhibitors of β-lactamases can help overcome this resistance. So, while β-lactamase inhibitors are not antimicrobials themselves when administered along with a β-lactam, they can inhibit any β-lactamases present and allow the β-lactam to function in killing bacteria. Thus, β-lactamase inhibitors are called adjuvants or helpers.

Two classes of β-lactamases inhibitors are available (Alcock et al., 2023):

  • Serine β-lactamase inhibitors (ARO:3007128)
  • Metallo-β-lactamase inhibitors (ARO:3007129)
    • These target Ambler class B (metallo-) β-lactamases
    • Examples include
      • bispicen
      • trispicen
      • trispicen A
      • nordihydroguaiaretic acid

References

Alcock, B. P., Huynh, W., Chalil, R., Smith, K. W., Raphenya, A. R., Wlodarski, M. A., Edalatmand, A., Petkau, A., Syed, S. A., Tsang, K. K., Baker, S. J. C., Dave, M., McCarthy, M. C., Mukiri, K. M., Nasir, J. A., Golbon, B., Imtiaz, H., Jiang, X., Kaur, K., Kwong, M., Liang, Z. C., Niu, K. C., Shan, P., Yang, J. Y. J., Gray, K. L., Hoad, G. R., Jia, B., Bhando, T., Carfrae, L. A., Farha, M. A., French, S., Gordzevich, R., Rachwalski, K., Tu, M. M., Bordeleau, E., Dooley, D., Griffiths, E., Zubyk, H. L., Brown, E. D., Maguire, F., Beiko, R. G., Hsiao, W. W. L., Brinkman, F. S. L., Van Domselaar, G., McArthur, A. G. (2023) CARD 2023: expanded curation, support for machine learning, and resistome prediction at the Comprehensive Antibiotic Resistance Database. Nucleic Acids Res. 51(D1), D690-D699. https://doi.org/10.1093/nar/gkac920

Aronson, J.K. (2016) Beta-lactamase inhibitors, Meyler's Side Effects of Drugs (Sixteenth Edition), Elsevier, 957-961, ISBN 9780444537164, https://doi.org/10.1016/B978-0-444-53717-1.00378-4.

April 2025, Shuchismita Dutta; Reviewed by Dr. Gregg Crichlow
https://doi.org/10.2210/rcsb_pdb/GH/AMR/drugs/OR/inh-blmase