Antibacterial P-lactams

In the relatively few years since the preparation of the previous volume in this series, the explosion of synthetic and clinical experimentation on the semi and totally synthetic antibacterial p-lactam antibiotics has continued, providing a rich body of literature from which to assemble this chapter. The search for utopiasporin, the perfect cephalosporin, continues. The improvements in. spectrum and clinical properties achieved to date, however, are largely incremental and have been achieved at the price of substantially higher costs to the patient. Nonetheless, these newer compounds are truly remarkable when compared with the properties of the fermentation-derived substances from which they have sprung. 

Also included in Volume 3 is a report (Chapter 5) written for the nonmedical scientist describing the clinical uses of the compounds that result from these efforts. The concluding chapters of Volume 3 review two new subjects that are currently at the forefront of p-lactam research. The first of these. Chapter 6, discusses the events that occur in the bacterial cells between cell wall biosynthesis inhibition and cell lysis. It addresses the problem of penicillin-tolerant strains that have the ability to survive in the presence of large amounts of p-lactam antibiotics. The last chapter (7) again turns to a newly discovered class of antibacterial P-lactam natural products. These newly discovered monocyclic compounds, called monobactams, appear to have clinical utility. 

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