JAC Advance Access published online on May 29, 2003
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkg286
© 2003 by The British Society for Antimicrobial Chemotherapy
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Review
1 GlaxoSmithKline, 1250 South Collegeville Road, Collegeville,
PA 19426-0989, USA
* Corresponding author. E-mail: JaneFinlay-1{at}gsk.com.
Clavulanate is a broad-spectrum
Keywords: A review of the antimicrobial activity of clavulanate
-lactamase
inhibitor, with activity against many of the chromosomally and plasmid-mediated -lactamases of both Gram-positive and
Gram-negative bacteria. Although clavulanate has minimal antibacterial
activity in vitro, accumulating evidence suggests
that it may have an effect on pathogenic bacteria regardless of -lactamase production. Like other -lactams, clavulanate has been shown
to bind to penicillin-binding proteins (PBPs) in Gram-positive and
Gram-negative bacteria. It was found to bind selectively to PBP3
in Streptococcus pneumoniae. It has been suggested
that complementary binding to different PBPs and subsequent effects
on autolysis contribute to the enhancement of the activity of other -lactams by clavulanate. In addition,
co-amoxiclav has been shown to enhance the intracellular killing
functions of human polymorphonuclear cells (PMNs) in studies undertaken
with -lactamase-producing and non--lactamase-producing strains of bacteria.
These data from in vitro and cell culture systems
have been reflected in vivo, where clavulanate
enhanced the activity of amoxicillin against non--lactamase-producing
organisms. Further studies are required to determine whether the
effects seen within in vitro and in
vivo animal studies have clinical significance.-lactamase, clavulanate, Streptococcus pneumoniae
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