Cell wall inhibitor

Bacterial cell wall synthesis inhibitor (D-Ala-D-Ala)

Bacterial cell wall synthesis inhibitor (D-Ala-D-Ala) — mechanism peg (Ballicules) — Cell wall inhibitor — mechanism card

Blocks bacterial cell-wall cross-linking
Bactericidal against Gram-positives, including MRSA
Resistance = D-Ala-D-Lac substitution (VRE) — the binding site itself is changed

Binds D-Ala-D-Ala, blocking cell wall cross-linking
Nephrotoxicity at high exposure

Drugs with this mechanism (1)

Vancomycin — Glycopeptide mainstay for MRSA; IV for systemic, oral for C. difficile.

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