Sherris Medical Microbiology, 7e >Antibacterial Agents and Resistance
Kenneth J. Ryan+
TABLE 23–1Characteristics of Antibacterial Drugs
TARGET/REPRESENTATIVE DRUGS
CHARACTERISTICS
Cell Wall Synthesis
β-Lactams
Bactericidal against a variety of bacteria; inhibit penicillin-binding proteins
Penicillins
Natural penicillins: penicillin G, penicillin V
Active against gram-positive bacteria and some gram-negative cocci
Penicillinase-resistant: methicillin, dicloxicillin
Similar to the natural penicillins, but resistant to inactivation by the penicillinase of staphylococci
Broad-spectrum: ampicillin, amoxicillin
Similar to the natural penicillins, but more active against gram-negative organisms
Extended-spectrum: ticarcillin, piperacillin
Increased activity against gram-negative rods, including Pseudomonas species, and anaerobes
including Bacteroides fragilis. Usually combined with beta-lactamase inhibitors
Cephalosporins
Some are more effective against gram-negative bacteria and less susceptible to destruction by βlactamases
Cephalexin, cefoxitin, ceftriaxone, cefepime, ceftaroline, ceftolozane
Carbapenems
Resistant to inactivation by β-lactamases. Many gram-positive and gram-negative bacteria including
anaerobes are susceptible
Imipenem, meropenem, doripenem, ertapenem
Monobactams
Resistant to β-lactamases. Purely gram-negative coverage, primarily active against members of the
family Enterobacteriaceae
Aztreonam
Non–β-Lactams
Vancomycin, teicoplanin, telavancin
Bactericidal against gram-positive bacteria
Bacitracin
Bactericidal against gram-positive bacteria
Protein Synthesis
Aminoglycosides
Bactericidal against gram-negative aerobic and facultative bacteria
Gentamicin, tobramycin
Tetracyclines
Bacteriostatic against some gram-positive and gram-negative bacteria
Tetracycline, doxycycline, inocycline
Chloramphenicol
Bacteriostatic and broad spectrum
Macrolides
Bacteriostatic against many gram-positive bacteria as well as some mycobacteria
Erythromycin, clarithromycin, azithromycin
Lincosamides
Bacteriostatic against a variety of gram-positive and gram-negative bacteria, including anaerobes
Clindamycin
Oxazolidinones
Bacteriostatic against a variety of gram-positive bacteria and mycobacteria
Linezolid
Streptogramins
A synergistic combination of two drugs that bind to two different ribosomal sites. Individually each drug
is bacteriostatic, but together they are bactericidal. Effective against a variety of gram-positive
bacteria, including Enterococcus faecium
Quinupristin, dalfopristin
Nucleic Acid Synthesis
Fluoroquinolones
Bactericidal against a wide variety of gram-positive and gram-negative bacteria
Ciprofloxacin, levofloxacin, moxifloxacin
Rifamycins
Bactericidal against gram-positive and some gram-negative bacteria. Often used to treat infections
caused by Mycobacterium tuberculosis and as prophylaxis for close exposure to Neisseria
meningitidis
Rifampin, rifaximin, rifapentine
Folate Biosynthesis
Sulfonamides
Bacteriostatic against a variety of gram-positive and gram-negative bacteria
Trimethoprim
Often used in combination with a sulfa drug for a synergistic effect
Cell Membrane Integrity
Polymyxin B, colistin
Bactericidal against gram-negative cells by damaging cell membranes
Daptomycin
Bactericidal against gram-positive bacteria
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