What are beta-lactam (β-lactam) antibiotics?

From the Guidelines

Antibiotics should be used to treat bacterial infections, and the choice of antibiotic, dosage, and duration of treatment depend on the type and severity of the infection, with the goal of minimizing morbidity, mortality, and improving quality of life. When considering the use of antibiotics, it's essential to note that they are ineffective against viral infections like colds or flu, and overuse or misuse can lead to antibiotic resistance, making infections harder to treat in the future 1.

Key Considerations for Antibiotic Use

• The specific antibiotic, dosage, and duration of treatment should be determined based on the type and severity of the infection, as well as the patient's individual needs and medical history 1.
• Antibiotics work by targeting bacterial cell walls, protein synthesis, or DNA replication—structures and processes that differ from human cells 1.
• To use antibiotics effectively, it's crucial to complete the full prescribed course, even if symptoms improve, take them at regular intervals as directed, and with food if recommended 1.
• Therapeutic drug monitoring (TDM) may be necessary to ensure optimal antibiotic concentrations and minimize the risk of adverse events, particularly in critically ill patients 1.

Administration of Beta-Lactam Antibiotics

• Prolonged or continuous infusions of beta-lactam antibiotics may be beneficial for the treatment of infections due to non-fermenting Gram-negative bacilli, such as P. aeruginosa, in critically ill patients 1.
• A loading dose should be administered before starting continuous infusion to rapidly achieve effective antibiotic concentrations 1.
• The use of a loading dose should be independent of the continuous or intermittent administration of beta-lactam antibiotics, and the total daily dose should be adjusted according to the presence of organ failure, particularly acute kidney injury 1.

Conclusion is not allowed, so the answer will continue without a conclusion section, and the references will be cited in the text as instructed.

The choice of antibiotic, dosage, and duration of treatment should be guided by the principles of antimicrobial stewardship, with the goal of minimizing morbidity, mortality, and improving quality of life, as emphasized in the guidelines from the French Society of Pharmacology and Therapeutics and the French Society of Anaesthesia and Intensive Care Medicine 1.

From the FDA Drug Label

Amoxicillin is similar to penicillin in its bactericidal action against susceptible bacteria during the stage of active multiplication. It acts through the inhibition of cell wall biosynthesis that leads to the death of the bacteria

• Mechanism of Action: Amoxicillin is a bactericidal antibiotic, meaning it kills bacteria by inhibiting cell wall biosynthesis.
• Antimicrobial Activity: Amoxicillin is active against a variety of microorganisms, including both Gram-Positive and Gram-Negative bacteria, such as Streptococcus pneumoniae, Escherichia coli, and Haemophilus influenzae 2

From the Research

Key Points for Antibiotic Use

• The appropriate use of antibiotics in hospital settings involves several key points, including getting appropriate microbiological samples before antibiotic administration and carefully interpreting the results 3.
• Antibiotics should be used to treat infections, not to 'treat' fever, and the root cause of fever should be investigated prior to starting treatment 3.
• Empirical antibiotic treatment should be started after taking cultures, tailoring it to the site of infection, risk factors for multidrug-resistant bacteria, and the local microbiology and susceptibility patterns 3.

Duration of Antibiotic Treatment

• There is increasing evidence to support shorter durations of antibiotic treatment for common infections, including community-acquired pneumonia, intraabdominal sepsis, gram-negative bacteraemia, and vertebral osteomyelitis 4.
• Treatment durations for many common infections have been based on expert opinion rather than randomized trials, but recent studies have demonstrated the noninferiority of short-course therapy for these conditions 4.

Timing of Antibiotic Therapy

• Rapid initiation of antibiotic treatment is crucial in patients with severe infections such as septic shock and bacterial meningitis, but may not be as important for other infectious syndromes 5.
• Withholding antibiotic therapy until diagnostic results are available and a diagnosis has been established (e.g. by 4-8 hours) seems acceptable in most cases unless septic shock or bacterial meningitis are suspected 5.

Types of Antibiotics

• Macrolide antibiotics have been in use since the early 1950s, and newer macrolides such as clarithromycin, roxithromycin, dirithromycin, and azithromycin have improved pharmacokinetic parameters and tissue affinity 6.
• The choice of antibiotic therapy should be based on patient-specific characteristics, including the severity of illness, source of infection, and local microbiology and susceptibility patterns 7.