Cell wall inhibitor
Bacterial cell wall synthesis inhibitor (D-Ala-D-Ala)
- Blocks bacterial cell-wall cross-linking
- Binds D-Ala-D-Ala
- Bactericidal against Gram-positives, including MRSA
- Resistance = D-Ala-D-Lac substitution (VRE) — the binding site itself is changed
- Nephrotoxicity at high exposure
Drugs with this mechanism (1)
- Vancomycin — Glycopeptide mainstay for MRSA; IV for systemic, oral for C. difficile.
Self-check
- Which peptide terminus does the cell-wall inhibitor in this deck bind?
D-Ala-D-Ala. - Which substitution produces the VRE resistance described here?
D-Ala-D-Lac.
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