A review of the role of beta-lactamase-producing bacteria in obstetric-gynecologic infections.

beta-Lactam antibiotics are the most commonly used antibiotics in obstetrics and gynecology. However, they are susceptible to inactivation when attacked by beta-lactamase, an enzyme produced by many bacterial species. During the past three decades, numerous penicillins and cephalosporins have been made with a stable beta-lactam ring that resists enzyme attack. More recently enzyme inhibitors have been discovered that inactivate beta-lactamase. The combination of an enzyme inhibitor with a beta-lactam antibiotic, such as ampicillin, restores the antimicrobial activity of the beta-lactam against formerly resistant strains of staphylococci, Haemophilus influenzae, Enterobacteriaceae, and Bacteroides fragilis.