Glycopeptide antibiotics such as vancomycin and teicho-planin bind the D-alanine dipeptide and inhibit the transglycosylation and transpeptidation steps in peptido-glycan synthesis of the cell wall. Gram-negative bacteria are generally not affected by glycopeptide antibiotics as these antibiotics cannot transverse the outer membrane and gain access to the peptidoglycan in the cell wall. Glycopeptide antibiotic resistance in Gram-positive bacteria is most often mediated by changes in the pep-tidoglycan side-chain thus circumventing the effects of the antibiotic.[2,4]
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