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Antibacterial drugs
What Are the Different Types of Antibacterial Drugs?
Antibacterial drugs come in many different types. Some are broad-spectrum,
which means they work against a wide variety of bacteria. Others are targeted
against specific types of bacteria.
Read this;
structure and classification of bacteria
Your doctor will prescribe the right type of antibacterial drug for your
infection, based on the type of bacteria causing it. Some common types of
antibacterial drugs include penicillins, cephalosporins, macrolides,
quinolones, and tetracyclines.
Chemical classification
Sulfonamides and related drugs:
- Sulfadiazine
and others,
- Sulfones—Dapsone
(DDS),
- Paraaminosalicylic
acid (PAS).
Diaminopyrimidines:
- Trimethoprim,
- Pyrimethamine.
Quinolones:
- Nalidixic
acid,
- Norfloxacin,
- Ciprofloxacin,
- Gatifloxacin,
etc.
β-lactam antibiotics:
- Penicillins,
- Cephalosporins,
- Monobactams,
- Carbapenems,
- β-lactamase
inhibitors—Clavulanic acid, Sulbactam.
Tetracyclines:
- Oxytetracycline,
- Doxycycline,
etc.
Nitrobenzene derivative:
- Chloramphenicol.
Aminoglycosides:
- Streptomycin,
- Gentamicin,
- Amikacin,
- Neomycin
Macrolide antibiotics:
- Erythromycin,
- Roxithromycin,
- Clarithromycin,
- Azithromycin.
Lincosamide antibiotics:
- Lincomycin,
- Clindamycin.
Glycopeptides:
- Vancomycin,
- Teicoplanin.
Oxazolidinone:
- Linezolid.
Polypeptide antibiotics:
- Polymyxin-B,
- Colistin,
- Bacitracin,
- Tyrothricin.
Nitrofuran derivatives:
- Nitrofurantoin,
- Furazolidone.
Nitroimidazoles:
- Metronidazole,
- Tinidazole
Nicotinic acid derivatives:
- Isoniazid,
- Pyrazinamide,
- Ethionamide.
Others:
- Rifampin,
- Spectinomycin,
- Cycloserine,
- Viomycin,
- Ethambutol,
- Thiacetazone,
- Clofazimine.
Read this
Mechanism Classification
Inhibit cell wall
synthesis:
- Penicillins,
- Cephalosporins,
- Cycloserine,
- Vancomycin,
- Bacitracin.
Cause
leakage from cell
membranes:
Polypeptides
- Polymyxins,
- Colistin,
- Bacitracin.
Inhibit protein
synthesis:
- Tetracyclines,
- Chloramphenicol,
- Erythromycin,
- Clindamycin,
- Linezolid.
Cause misreading of
mRNA code and affect permeability:
Aminoglycosides
- Streptomycin,
- Gentamicin, etc.
Inhibit DNA gyrase:
Fluoroquinolones
- Ciprofloxacin etc.
Interfere with DNA
function:
- Rifampin,
- Metronidazole.
Interfere with
intermediary metabolism:
Sulfonamides,
- Sulfones,
- PAS,
- Trimethoprim,
Ethambutol.
Action Classification
Primarily bacteriostatic
- Sulfonamides
- Ethambutol
- Tetracyclines
- Clindamycin
- Chloramphenicol
- Linezolid
- Erythromycin
- Sulfonamides
Primarily bactericidal
- Penicillins
- Cephalosporins
- Aminoglycosides
- Vancomycin
- Polypeptides
- Nalidixic acid
- Rifampin
- Ciprofloxacin
- Cotrimoxazole
- Metronidazole
- Isoniazid
- Pyrazinamide
Spectrum Activity Classification
Narrow spectrum
- Streptomycin
- Penicillin G
- Erythromycin
Intermediate spectrum
- Aminopenicillins
- Cephalosporins (2nd/3rd Gen)
- Fluoroquinolones
- Newer macrolides
Broad-spectrum
- Tetracyclines
- Chloramphenicol
Sulfonamides
Short-acting (4–8 hr):
- Sulfadiazine.
Intermediate-acting
(8–12 hr):
- Sulfamethoxazole.
Long-acting (~7 days):
- Sulfadoxine,
- Sulfamethopyrazine.
Special Purpose sulfonamides:
- Sulfacetamide sod.
- Sulfasalazine,
- Mafenide,
- Silver sulfadiazine.
Combinations
Cotrimoxazole
(Trimethoprim-Sulfamethoxazole 1:5)
Cotrimazine
(Trimethoprim-Sulfadiazine 1:5)
PENICILLINS
A). Natural Penicillin
- Benzyl Penicillin (Penicillin
G)
B). Semisynthetic
Penicillins
1). Acid resistant alternative to penicillin G
- Phenoxymethyl penicillin
(Penicillin V).
2). Penicillinase resistant penicillins
- Methicillin,
- Cloxacillin.
3). Extended-spectrum penicillins
(a) Aminopenicillins:
- Ampicillin,
- Bacampicillin,
- Amoxicillin.
(b). Carboxypenicillins:
- Carbenicillin,
- Ticarcillin.
(c). Ureidopenicillins:
- Piperacillin,
- Mezlocillin.
C). β-lactamase
inhibitors
- Clavulanic acid,
- Sulbactam,
- Tazobactam
CEPHALOSPORINS
First-generation
Parenteral
- Cephalothin
- Cefazolin
Oral
- Cephalexin
- Cephradine
- Cefadroxil
Second generation
Parenteral
- Cefuroxime
- Cefoxitin
Oral
- Cefaclor
- Cefuroxime axetil
- Cefprozil
Third generation
Parenteral
- Cefotaxime
- Ceftizoxime
- Ceftriaxone
- Ceftazidime
- Cefoperazone
Oral
- Cefixime
- Cefpodoxime proxetil
- Cefdinir
- Ceftibuten
- Ceftamet pivoxil
Fourth generation
Parenteral
- Cefepime
- Cefpirome
MONOBACTAMS
- Aztreonam: 0.5–2 g i.m. or i.v.
6–12 hourly;
CARBAPENEMS
Imipenem-cilastatin:
- 0.5 g i.v. 6 hourly (max 4
g/day).
Meropenem:
- 0.5–2 g i.v. 8 hourly
(10–20 mg/kg every 8 hours);
Faropenem:
- 200-300 mg TDS oral;
Aminoglycoside
Antibiotics
Systemic aminoglycosides
- Streptomycin
- Gentamicin
- Kanamycin
- Tobramycin
- Amikacin
- Sisomicin
- Netilmicin
Topical aminoglycosides
- Neomycin
- Framycetin
Quinolones
Non-Fluorinated Quinolone
- Nalidixic acid
First-generation
Fluoroquinolones
- Norfloxacin
- Ofloxacin
- Ciprofloxacin
- Pefloxacin
Second generation Fluoroquinolones
- Lomefloxacin
- Levofloxacin
- Sparfloxacin
- Gatifloxacin
- Moxifloxacin
Third generation
Fluoroquinolones
- Gemifloxacin
- Prulifloxacin
Macrolide Antibiotics
Erythromycin:
- 250–500 mg 6 hourly (max. 4 g/day),
- children 30–60 mg/kg/day.
Roxithromycin:
- 150–300 mg BD 30 min before meals,
- children 2.5–5 mg/kg BD;
Clarithromycin:
- 250 mg BD for 7 days;
- severe
cases 500 mg BD up to 14 days;
Azithromycin:
- 500 mg once daily 1 hour before
or 2 hours after food (children above 6 months 10 mg/kg) for 3 days is sufficient for most infections;
Spiramycin:
- 3 million units (MU) twice daily
oral;
Chloramphenicol
Chloramphenicol:
250–500 mg 6 hourly oral (max 28 g total in a course), children
25–50 mg/kg/day; 0.5–1% topically in the eye, 5– 10% topically in-ear; rarely 1% on the skin;
Chloramphenicol
palmitate
(Tasteless insoluble ester of chloramphenicol for
liquid oral formulation):
Chloramphenicol
succinate
(soluble ester of chloramphenicol for i.v. injection):
Tetracyclines
Oxytetracycline:
- 250–500 mg TDS–QID oral,
- 500 mg
6–12 hourly by slow i.v. in; 1–3% by topical application;
Tetracycline:
- 250–500 mg TDS–QID oral; 1–3%
topically in the eye/ear/on the skin;
Demeclocycline
(Demethylchlortetracycline):
- 300–600 mg BD oral;
Doxycycline:
- 200 mg initially followed by
100–200 mg OD oral;
Minocycline:
- 100 mg OD–BD oral;
Lincosamide Antibiotics
Lincomycin:
- 500 mg TDS–QID oral;
- 600 mg
i.m. or by i.v infusion 6–12 hrly;
Clindamycin:
- 150–300 mg QID oral;
- 200–600 mg
i.v. 8 hourly;
Aminocyclitol Antibiotic
Spectinomycin:
- Gonorrhea—2 g i.m. single dose
(4 g in resistant cases);
- Disseminated gonococcal
infection—2 g i.m. BD.
Glycopeptide Antibiotics
Vancomycin:
- 125–500 mg oral, 0.5 g 6 hourly
or 1.0 g 12 hourly by i.v. infusion over 1 hour;
Teicoplanin:
- 400 mg first day—then 200 mg
daily i.v. or i.m.;
- severe infection 400 mg 12
hourly × 3 doses—then 400 mg daily;
Oxazolidinone
Linezolid:
- 600 mg BD, oral/i.v.;
Polypeptide Antibiotics
Polymyxin B:
- 5000–10,000 U/g for topical
application(1 mg=10,000 U);
Colistin sulfate:
- 25–100 mg TDS oral;
Bacitracin:
- 250–500 U/g for topical
application (IU = 26 ÎĽg);
Tyrothricin:
- 0.2–0.5 mg/g for topical
application
Urinary Antiseptics
Nitrofurantoin:
- 50–100 mg 3 to 4 times a day
oral;
Methenamine (Hexamine)
mandelate:
- 1.0 g 3–4 times/day
Nalidixic acid:
- 0.5–1 g TDS–QID oral
Antileprotic Drugs
Sulfone
- Dapsone (DDS)
Phenazine derivative
- Clofazimine
Antitubercular drugs
- Rifampin,
- Ethionamide
Other antibiotics
- Ofloxacin,
- Minocycline,
- Clarithromycin
Antitubercular Drugs
First-line drugs
- Isoniazid (H)
- Rifampin (R)
- Pyrazinamide (Z)
- Ethambutol (E)
- Streptomycin (S)
Second-line drugs
- Thiacetazone (Tzu)
- Paraaminosalicylic acid
(PAS)
- Ethionamide (Item)
- Cycloserine (Cys)
- Kanamycin (Kmc)
- Amikacin (Am)
- Capreomycin (Cpr)
Newer drugs
- Ciprofloxacin
- Ofloxacin
- Clarithromycin
- Azithromycin
- Rifabutin
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