β-lactamase-resistant penicillins — Identify the penicillin that is NOT resistant to staphylococcal β-lactamase.

Difficulty: Easy

Correct Answer: Carbenicillin

Explanation:


Introduction / Context:
Staphylococcal penicillinase (a β-lactamase) hydrolyzes many penicillins. Certain agents (e.g., oxacillin, nafcillin, methicillin) are engineered to resist this enzyme, making them effective for methicillin-susceptible S. aureus (MSSA).



Given Data / Assumptions:

  • Oxacillin, nafcillin, methicillin: classic β-lactamase–resistant antistaphylococcal penicillins.
  • Carbenicillin: extended-spectrum carboxypenicillin active against Pseudomonas, but β-lactamase-susceptible.


Concept / Approach:
Select the option that lacks β-lactamase stability against staphylococcal enzymes. Carbenicillin does not have the steric features that protect the β-lactam ring from penicillinase.



Step-by-Step Solution:

Group β-lactamase–resistant choices (oxacillin, nafcillin, methicillin).Contrast with carbenicillin (β-lactamase-susceptible).Choose carbenicillin as the exception.


Verification / Alternative check:
Therapeutic guidelines use oxacillin/nafcillin (or cefazolin) for MSSA; carbenicillin is not used for that purpose.



Why Other Options Are Wrong:

  • Oxacillin, nafcillin, methicillin: designed to resist staphylococcal penicillinase.


Common Pitfalls:
Assuming broad spectrum (e.g., antipseudomonal) implies penicillinase resistance; spectrum and enzyme stability are distinct properties.



Final Answer:
Carbenicillin

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