Antibiotics: non beta-lactam cell wall synthesis inhibitors

Types of non beta-lactam cell wall synthesis inhibitors

Bacitracin

Glycopeptide

How does bacitracin work

Forming a complex with the peptidoglycan monomer carrier interfering with its trans-membrane transfer

Bacitracin active against

Gram pos bacteria

No systemic use due to nephrotoxicity

Glycopeptide ABs

Vancomycin

Teicoplanin

Vancomycin function against

Gram positive bacteria; strep, satph, enterococcus, listeria, corynebacterium, actinomycetes, clostridia, MRSA

Vancomycin can penetrate

CSF - meninges

Bone

Pericardium

Ascites

Synovia

Vancomycin adverse effects

Nephrotoxicity when comibned with aminoglycosides

Glycopeptide resistance

Vancomycin resistant enterococci (VRE); due to presence of operons encoding modified target and enzymes eliminating the high affinity target