Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: EC:6.2.1.7 (BAL)
1,977 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Beta-lactams are among the most successful classes of antibiotics, both medically and commercially. However, more than 60 years of extensive, and sometimes inappropriate, use has enabled bacteria to develop a broad range of resistance mechanisms. Nevertheless, the versatility of the beta-lactam core structure, combined with the innovation of medicinal chemists, has repeatedly led to the development of new generations of beta-lactam antibiotics that are capable of overcoming the problems caused by mounting bacterial resistance. In particular, two cephalosporin derivatives, ceftobiprole and ceftaroline (Forest Laboratories Inc/AstraZeneca plc), as well as the carbapenem razupenem (Novartis AG/Dainippon Sumitomo Pharma Co Ltd), have demonstrated potent activity against the gram-positive 'superbug' MRSA. CXA-101 (Calixa Therapeutics Inc) is a new member of the series of cephalosporins that are effective against gram-negative bacteria such as Pseudomonas aeruginosa. The compound has been demonstrated to be particularly stable to degradation by the class C beta-lactamases in P. aeruginosa. Furthermore, siderophore-containing monobactams such as BAL-30072 (Basilea Pharmaceutica International Ltd) are inherently stable to hydrolysis by metallo-beta-lactamases, and act as 'Trojan horses' by being transported into gram-negative cells using endogenous bacterial iron-uptake systems. Considering the significant medical need for novel antibiotics that are active against resistant strains of bacteria, it is hoped several of the new generation of beta-lactam compounds that are in clinical development will soon reach the market.
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PMID:New molecules from old classes: revisiting the development of beta-lactams. 1969 75

Hospital-acquired pneumonia is diagnosed in patients who, in addition to abnormal shadowing on chest radiography, have >or=2 of the following: fever, abnormal white blood cell count and purulent discharge. Treatment effect is judged from clinical symptoms and microorganism test results 2-3 days after the start of treatment, and reassessment is made with regard to change, addition or discontinuation of antimicrobial agents. Coordination with the microbiology laboratory is extremely important in diagnosing infectious diseases. Microorganisms isolated from tracheal aspirate at 10(6) cfu/mL (3+), from BAL at 10(4)-10(5) cfu/mL (2+) and from a protected specimen brush at 10(3) cfu/mL (1+) have a high possibility of being the causative microorganisms. Pneumonia can almost be ruled out when no significant microbes are detected from the lower respiratory tract in patients with suspected ventilator-assisted pneumonia (when no change has been made to antimicrobial administration within 72 h). When MRSA or Pseudomonas aeruginosa are not detected in sputum tests, involvement of these drug-resistant bacteria may be considered unlikely, and the case treated accordingly. Involvement of aspiration is suspected when a number of pathogens are observed in lower respiratory tract specimens. When antimicrobials are administered with reference to breakpoint concentrations in Western countries, differences in dosage between these countries and Japan need to be considered.
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PMID:Diagnosis of hospital-acquired pneumonia and methods of testing for pathogens. 1985 17