Combating bacterial resistance in skin and skin-structure infection: Importance of β-lactamase inhibition

Joseph C. Chan

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Serious skin and skin-structure infections may require parenteral antibiotic therapy. Such infections are generally polymicrobial, and they often involve both gram-positive and gram-negative aerobes as well as anaerobic bacteria. Effective treatment thus requires the use of a broad- spectrum antibiotic or combination therapy. The development of antibiotic resistance by clinically important pathogens has significantly increased the difficulty of treating skin and skin-structure infections. One of the major mechanisms of resistance observed in organisms likely to be associated with such infections is the development of β-lactamases that inactivate β- lactam antibiotics. Two approaches have been taken to combat this problem: the use of β-lactam/β-lactamase inhibitor combinations and the development of β-lactamase-stable drugs. Both strategies have resulted in treatments that are clinically and bacteriologically effective in patients with skin and skin-structure infections. The use of one β-lactam/β-lactamase inhibitor combination, ampicillin/sulbactam, has been demonstrated to be more cost- effective than treatment with β-lactamase-stable antibiotics, such as cefoxitin and imipenem/cilastatin, for this indication.

Original languageEnglish (US)
Pages (from-to)13-18
Number of pages6
JournalAmerican journal of therapeutics
Issue number1
StatePublished - Jan 1999


  • β- lactamase
  • Ampicillin/sulbactam
  • Antibiotic resistance
  • Cefazolin
  • Cefoxitin
  • Imipenem/cilastatin

ASJC Scopus subject areas

  • Pharmacology


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