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Currently, four inhibitor\u2010penicillin combinations are in clinical use: ampicillin\u2010sulbactam, amoxicillin\u2010clavulanate, ticarcillin\u2010clavulanate, and piperacillin\u2010tazobactam. Of these, ticarcillin\u2010clavulanate and piperacillin\u2010tazobactam have the broadest spectra of activity that includes Pseudomonas aeruginosa. Many factors influence the activity and pharmacodynamics of these combinations, including potency of both agents, pharmacokinetics of the inhibitor, type and quantity of \u03b2\u2010lactamase produced by the target bacterium, and potential for the inhibitor to induce expression of chromosomal cephalosporinases in the target bacterium. Although ticarcillin\u2010clavulanate and piperacillin\u2010tazobactam have similar spectra of activity, they have many differences. Most notable are increased potency of piperacillin against Enterobacteriaceae and <jats:italic>P. aeruginosa<\/jats:italic>, increased activity of piperacillin\u2010tazobactam against gram\u2010negative pathogens producing penicillin\u2010sensitive enzyme (PSE)\u2010class \u03b2\u2010lactamase or hyperproducing other plasmid\u2010encoded \u03b2\u2010lactamases, and the more favorable pharmacokinetics of tazobactam. In the treatment of <jats:italic>P. aeruginosa<\/jats:italic> infections, the potential for clavulanate to induce expression of chromosomal cephalosporinase and antagonize antibacterial activity of ticarcillin is a concern, especially in patients who lack protective host defenses. These are not concerns with piperacillin\u2010tazobactam.<\/jats:p>","DOI":"10.1592\/phco.20.14.213s.35045","type":"journal-article","created":{"date-parts":[[2004,6,15]],"date-time":"2004-06-15T15:42:05Z","timestamp":1087314125000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["\u03b2\u2010Lactamase Inhibitor Combinations with Extended\u2010Spectrum Penicillins: Factors Influencing Antibacterial Activity against Enterobacteriaceae and <i>Pseudomonas aeruginosa<\/i>"],"prefix":"10.1002","volume":"20","author":[{"given":"Philip 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