REVIEW Sultamicillin is an antibiotic combination (codrug or mutual prodrug). It contains esterified ampicillin and sulbactam and is marketed under a number of trade names, including Saltum from Morepen Lab and Unasyn from Pfizer. It is a prodrug ester, which upon hydrolysis releases the active ampicillin and the beta-lactamase inhibitor sulbactam. Sulbactam extends the antibacterial activity of the ampicillin to include some beta-lactamase-producing strains of bacteria that would otherwise be resistant. The ampicillin inhibits bacterial cell wall synthesis by binding to one or more of the penicillin-binding proteins (PBPs). This inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell walls, thus inhibiting cell wall biosynthesis. Bacteria eventually lyse due to ongoing activity of cell wall autolytic enzymes (autolysins and murein hydrolases) while cell wall assembly is arrested.
REFERENCES
[1]
1,1-Dioxopenicillanoyloxymethyl 6-(D-alpha-amino-alpha-phenylacetamido)penicillanate Neth. Appl. (1982), NL 8104938 A 19820517.
[2]
Godtfredsen, Wagn O.; Von Daehne, Welf beta-Lactam compounds, their antibacterial compositions and their use U.S. (1982), US 4342772 A 19820803.
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