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Aminopenicillin Mechanisms

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Aminopenicillins are antibiotics that belong to the penicillin family. Like penicillins, aminopenicillins are beta-lactam antibiotics, which work by inhibiting bacterial cell wall synthesis. They are classified as bactericidal agents. Aminopenicillins have a broader spectrum of activity than penicillin and are not degraded by acid hydrolysis and can therefore be administered orally. Aminopenicillins are susceptible to beta-lactamase, which is why they are often given with beta-lactamase inhibitors like clavulanic acid. Aminopenicillins are used to treat most gram-positive infections and some gram-negative infections such as Escherichia coli and Haemophilus influenzae. Common aminopenicillins include ampicillin and amoxicillin. Adverse reactions include hypersensitivity reactions, ampicillin rash when given to patients with infectious mononucleosis, and pseudomembranous colitis.
8 KEY FACTS
INDICATIONS
Broader Spectrum
Broad Spectrum of Colors

Aminopenicillins have a wider spectrum of coverage than penicillins because they can cover some gram-negative bacteria, like Escherichia coli and Haemophilus influenzae.

DRUG NAMES
Ampicillin
Amp-pencil

Ampicillin is a beta-lactam antibiotic in the aminopenicillin family. It can be used against gram-positive organisms and limited gram-negative bacteria. It can sometimes cause a rash if accidentally used for patients with mononucleosis.

Amoxicillin
Armor-ox-pencil

This is a popular oral beta-lactam antibiotic used for infections such as otitis media, skin infections, and strep throat. It is susceptible to degradation by beta-lactamase producing bacteria, and is therefore often combined with beta-lactamase inhibitors like clavulanic acid.

MECHANISM AND CHARACTERISTICS
Beta-Lactamase Sensitive
Black-beta-fish-ace crying

Beta-lactamase is an enzyme that is produced by some bacteria to cleave beta-lactam antibiotics, rendering them ineffective. When an antibiotic is described as beta-lactamase sensitive, it means it is likely ineffective against beta-lactamase producing bacteria. Beta-lactamase inhibitors are commonly combined with penicillin group antibiotics to overcome resistance to these enzymes, and commonly used beta-lactamase inhibitors include clavulanic acid, sulbactam, and tazobactam.

Combine with Clavulanic Acid
Cleaver Acidic-lemon

Clavulanic acid is a beta-lactamase inhibitor that is commonly combined with penicillin group antibiotics to overcome resistance in bacteria that secrete beta-lactamase to inactivate most penicillins. Clavulanic acid shares a similar beta-lactam ring structure and is called a suicide inhibitor because it covalently binds to the active site of beta-lactamase, thus inactivating it. Clavulanic acid is commonly combined with amoxicillin and is called Augmentin.

SIDE EFFECTS
Hypersensitivity Reactions
Hiker-sensitive-crying

Because penicillin and aminopenicillins are relatively similar in structure, individuals with hypersensitivity reactions to penicillins may also demonstrate a hypersensitivity or anaphylactic reaction to aminopenicillins. A hypersensitivity or anaphylactic reaction is an overreaction of the body's immune response. Symptoms may include rashes, hives, itchy eyes, and a swollen tongue or face.

Ampicillin Rash
Amp-pencil Rash with Dermatologist

Patients with infectious mononucleosis caused by Epstein-Barr virus are sometimes misdiagnosed with streptococcal pharyngitis due to the similarity of symptoms and are given antibiotics like ampicillin. About 80-90% of patients with acute Epstein-Barr virus infection treated with ampicillin develop a diffuse red rash called ampicillin rash.

Pseudomembranous Colitis
Sumo-man-bra Colon

Ampicillin is associated with pseudomembranous colitis, an infection of the colon characterized by foul smelling diarrhea, fever, and abdominal pain caused by Clostridium difficile infection. Ampicillin is known to be an antibiotic that can precipitate pseudomembranous colitis due to a broad spectrum that can destroy normal gut flora, allowing the gut to be overrun with C. difficile.

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