Mechanism of action of vancomycin is
**Core Concept**
Vancomycin is a glycopeptide antibiotic that inhibits cell wall synthesis in Gram-positive bacteria. It binds to the D-alanyl-D-alanine (D-Ala-D-Ala) terminus of cell wall precursors, preventing the incorporation of these precursors into the bacterial cell wall.
**Why the Correct Answer is Right**
Vancomycin works by binding to the D-Ala-D-Ala terminus of cell wall precursors, which are necessary for the synthesis of peptidoglycan, a critical component of the bacterial cell wall. This binding prevents the incorporation of these precursors into the cell wall, ultimately inhibiting cell wall synthesis and leading to bacterial cell lysis. Vancomycin specifically targets the terminal D-Ala-D-Ala moiety, which is essential for the formation of cross-links between peptidoglycan chains.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because it does not accurately describe the mechanism of action of vancomycin. Vancomycin does not inhibit protein synthesis or DNA replication.
**Option B:** This option is incorrect because vancomycin does not act by inhibiting membrane-bound enzymes, such as beta-lactamases. Instead, it binds to cell wall precursors to prevent cell wall synthesis.
**Option C:** This option is incorrect because vancomycin does not target the bacterial cell membrane or inhibit membrane-bound enzymes.
**Clinical Pearl / High-Yield Fact**
Vancomycin is often used in combination with beta-lactam antibiotics to enhance its bactericidal activity against Gram-positive bacteria. This combination is particularly effective against methicillin-resistant Staphylococcus aureus (MRSA).
**Correct Answer:** B. Vancomycin inhibits cell wall synthesis by binding to the D-alanyl-D-alanine terminus of cell wall precursors.