You can work with Access through a connection (ODBC or OLEDB), as long as you only need to manage the "database" dimension of the file (tables and views, which are called "queries" in Access).
Once the connection is open (see here for connection strings), you can send SQL commands to your mdb database, such as (where cn
is here a connection object):
cn.execute "CREATE TABLE myTableName (myTable_id autoNumber, myTable_code Text, ...)"
Please note that MsAccess uses a specific DDL that looks like the standard T-SQL but is not really it. Check the syntax in MsAccess help.
Depending on your database (and its constraints, default values, primary keys used, relations, data validation rules, aso), transfering Access can be easy and straight or might not even be possible. You will encounter a problem each time your database implement an access-specific/non-standard SQL rule.
If you really need to convert your access data to something else, I'd adise you to (1) export it under MS-SQL (the free version will be ok, an upsizing wizard is available in Access or on this site), (2)use an additional tool like this one to generate a "CREATE DATABASE" SQL Script, including or not data inserts, (3) use this script to try to create the database and its data on another database server.