Antibiotic; Types, Indications/Uses , Side Effects, Interactions

Antibiotic
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Antibiotic also called an antibacterial is a type of antimicrobial drug used in the treatment and prevention of bacterial infections.They may either kill or inhibit the growth of bacteria. A limited number of antibiotics also possess antiprotozoal activity.Antibiotics are not effective against viruses such as the common cold or influenza; drugs which inhibit viruses are termed antiviral drugs or antivirals rather than antibiotics.

Sometimes the term antibiotic (which means “opposing life”) is used to refer to any substance used against microbes, synonymous with antimicrobial. Some sources distinguish between antibacterial and antibiotic; antibacterials are used in soaps and disinfectants, while antibiotics are used as medicine

New Antibiotics

Class Generic/Brand
Lipopeptides Daptomycin (Cubicin®), 2003
Fluoroquinolone Delafloxacin (Baxdela®), 2017
Lipoglycopeptides Telavancin (Vibativ®), 2009
Cephalosporin
(5th generation)
Ceftaroline (Teflaro®), 2010
Macrocyclics Fidaxomicin (Dificid®), 2011

ß-Lactam Antibiotics

Beta-lactam class of antibiotics includes penicillins, cephalosporins, monobactams, and carbapenems, all of which contain a β-lactam ring.

Penicillins

Antibiotics of the penicillin class are bactericidal and work by inhibiting the synthesis of bacterial cell walls. Penicillins are among the safest antibiotics.

Major health concerns: hypersensitivity reactions.

Generic Brand Name
Amoxicillin Amoxil, Polymox, Trimox, Wymox
Ampicillin Omnipen, Polycillin, Polycillin-N, Principen, Totacillin
Bacampicillin Spectrobid
Carbenicillin Geocillin, Geopen
Cloxacillin Cloxapen
Dicloxacillin Dynapen, Dycill, Pathocil
Flucloxacillin Flopen, Floxapen, Staphcillin
Mezlocillin Mezlin
Nafcillin Nafcil, Nallpen, Unipen
Oxacillin Bactocill, Prostaphlin
Penicillin G Bicillin L-A,
Crysticillin 300 A.S., Pentids, Permapen, Pfizerpen, Pfizerpen-AS, Wycillin
Penicillin V Beepen-VK, Betapen-VK, Ledercillin VK, V-Cillin K
Piperacillin Pipracil
Pivampicillin
Pivmecillinam
Ticarcillin Ticar

Cephalosporins

Cephalosporins are mainly bactericidal and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. Besides true cephalosporins (which are derived from cephalosporin C) this class includes oxacephems and carbacephems.

Major health concerns: platelet function abnormalities (rare).

Generic Brand Name
First Generation
Cefacetrile (cephacetrile) Celospor, Celtol, Cristacef
Cefadroxil (cefadroxyl) Duricef, Ultracef
Cefalexin (cephalexin) Keflex, Keftab
Cefaloglycin (cephaloglycin) Kefglycin
Cefalonium (cephalonium)
Cefaloridine (cephaloradine)
Cefalotin (cephalothin) Keflin
Cefapirin (cephapirin) Cefadyl
Cefatrizine
Cefazaflur
Cefazedone
Cefazolin (cephazolin) Ancef, Kefzol
Cefradine (cephradine) Velosef
Cefroxadine
Ceftezole
Second Generation
Cefaclor Ceclor, Ceclor CD, Distaclor, Keflor, Ranicor
Cefamandole Mandol
Cefmetazole
Cefonicid Monocid
Cefotetan Cefotan
Cefoxitin Mefoxin
Cefprozil (cefproxil) Cefzil
Cefuroxime Ceftin, Kefurox, Zinacef, Zinnat
Cefuzonam
Third Generation
Cefcapene
Cefdaloxime
Cefdinir Omnicef, Cefdiel
Cefditoren Spectracef
Cefetamet
Cefixime Suprax
Cefmenoxime Cefmax
Cefodizime
Cefotaxime Claforan
Cefpimizole
Cefpodoxime Vantin
Cefteram
Ceftibuten Cedax
Ceftiofur Excede
Ceftiolene
Ceftizoxime Cefizox
Ceftriaxone Rocephin
Cefoperazone Cefobid
Ceftazidime Ceptaz, Fortum, Fortaz, Tazicef, Tazidime
Fourth Generation
Cefclidine
Cefepime Maxipime
Cefluprenam
Cefoselis
Cefozopran
Cefpirome Cefrom
Cefquinome
Fifth Generation
Ceftobiprole Zeftera
Ceftaroline Teflaro
Not Classified
Cefaclomezine
Cefaloram
Cefaparole
Cefcanel
Cefedrolor
Cefempidone
Cefetrizole
Cefivitril
Cefmatilen
Cefmepidium
Cefovecin
Cefoxazole
Cefrotil
Cefsumide
Cefuracetime
Ceftioxide
Combinations
Ceftazidime/Avibactam Avycaz
Ceftolozane/Tazobactam Zerbaxa
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Monobactams

Generic Brand Name
Aztreonam Azactam, Cayston

Carbapenems

Carbapenems have incredibly broad spectrum of antimicrobial activity. Today these agents are among the most powerful antibiotics.

Generic Brand Name
Imipenem,
Imipenem/cilastatin
Primaxin
Doripenem Doribax
Ertapenem Invanz
Meropenem Merrem
Meropenem/vaborbactam Vabomere

Macrolide Antibiotics

Macrolides are bacteriostatic drugs that inhibit protein synthesis by targeting the 50S subunit.

Major health concerns: erythromycin estolate is hepatotoxic.

Generic Brand Name
Azithromycin Zithromax
Erythromycin
Clarithromycin Biaxin
Dirithromycin Dynabac
Roxithromycin Rulid, Surlid
Ketolides
Telithromycin Ketek

Lincosamides

Generic Brand Name
Clindamycin Cleocin
Lincomycin Lincocin

Streptogramins

Generic Brand Name
Pristinamycin Pyostacine
Quinupristin/dalfopristin Synercid

Aminoglycoside Antibiotics

Aminoglycosides are rapidly bactericidal antibiotics which inhibit protein synthesis. These agents mainly interfere with proofreading process. Aminoglycosides are the only bactericidal class among protein synthesis inhibitors.

Major health concerns: ototoxicity, nephrotoxicity.

Generic Brand Name
Amikacin Amikin
Gentamicin Garamycin, G-Mycin, Jenamicin
Kanamycin Kantrex
Neomycin Mycifradin, Myciguent
Netilmicin Netromycin
Paromomycin
Streptomycin
Tobramycin Nebcin

Quinolone Antibiotics

Fluoroquinolones directly inhibit the bacterial nucleic acid synthesis.

Major health concerns: QTc prolongation and/or torsade de pointes, tendonitis, tendon rupture, joint arthropathies.

Generic Brand Name
First Generation
Flumequine Flubactin
Nalidixic acid NegGam, Wintomylon
Oxolinic acid Uroxin
Piromidic acid Panacid
Pipemidic acid Dolcol
Rosoxacin Eradacil
Second Generation
Ciprofloxacin Cipro, Cipro XR, Ciprobay, Ciproxin
Enoxacin Enroxil, Penetrex
Lomefloxacin Maxaquin
Nadifloxacin Acuatim, Nadoxin, Nadixa
Norfloxacin Lexinor, Noroxin, Quinabic, Janacin
Ofloxacin Floxin, Oxaldin, Tarivid
Pefloxacin Peflacine
Rufloxacin Uroflox
Third Generation
Balofloxacin Baloxin
Gatifloxacin Tequin, Zymar
Grepafloxacin Raxar
Levofloxacin Cravit, Levaquin
Moxifloxacin Avelox, Vigamox
Pazufloxacin Pasil, Pazucross
Sparfloxacin Zagam
Temafloxacin Omniflox
Tosufloxacin Ozex, Tosacin
Fourth Generation
Besifloxacin Besivance
Delafloxacin Baxdela®
Clinafloxacin
Gemifloxacin Factive
Prulifloxacin Quisnon
Sitafloxacin Gracevit
Trovafloxacin Trovan

Sulfonamides

Sulfonamides act by inhibiting the pathway that bacteria use to synthesize folic acid. Sulfonamides with trimethoprim produce synergistic antibacterial activity.

Major health concerns: hypersensitivity reactions, renal damage, crystal nephropathy.

Generic Brand Name
Sulfamethizole Thiosulfil Forte
Sulfamethoxazole Gantanol, Urobak
Sulfisoxazole Gantrisin
Trimethoprim-Sulfamethoxazole Bactrim, Bactrim DS, Cotrim, Cotrim DS, Septra, Septra DS, Sulfatrim, Sulfatrim-DS

Tetracycline Antibiotics

Tetracyclines are protein synthesis inhibitors primary targeting the 30S ribosome. They are essentially bacteriostatic.

Major health concerns: photosensitivity, deposition in developing bones and teeth.

Generic Brand Name
Demeclocycline Declomycin
Doxycycline Doryx, Vibramycin
Minocycline Dynacin, Minocin, Monodox
Oxytetracycline Terramycin
Tetracycline Achromycin
Glycylcyclines
Tigecycline Tygacil

Other Antibiotics

Generic Brand Name
Chloramphenicol Chloromycetin
Metronidazole Flagyl, Helidac, Metizol, Metric 21, Neo-Metric, Noritate, Novonidazol
Tinidazole Tindamax
Nitrofurantoin Furadantin, Macrobid, Macrodantin
Glycopeptides
Vancomycin Vancocin
Teicoplanin Targocid
Lipoglycopeptides
Telavancin Vibativ
Oxazolidinones
Linezolid Zyvox
Cycloserine Seromycin
Rifamycins
Rifampin Rifadin
Rifabutin Mycobutin
Rifapentine Priftin
Rifalazil
Polypeptides
Bacitracin Baciguent
Polymyxin B
Tuberactinomycins
Viomycin
Capreomycin
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Mechanism of Action of Antibiotics

Antibiotics like the penicillins, is a beta-lactam antibiotic. By binding to specific penicillin-binding proteins (PBPs) located inside the bacterial cell wall, it inhibits the third and last stage of bacterial cell wall synthesis. Cell lysis is then mediated by bacterial cell wall autolytic enzymes such as autolysins; it is possible that antibiotic interferes with an autolysin inhibitor.

Antibiotic a beta-lactam antibiotic similar to penicillins, inhibits the third and final stage of bacterial cell wall synthesis by preferentially binding to specific penicillin-binding proteins (PBPs) that are located inside the bacterial cell wall. Penicillin-binding proteins are responsible for several steps in the synthesis of the cell wall and are found in quantities of several hundred to several thousand molecules per bacterial cell. Penicillin-binding proteins vary among different bacterial species. Thus, the intrinsic activity of  antibiotic as well as the other cephalosporins and penicillins against a particular organism depends on their ability to gain access to and bind with the necessary PBP. Like all beta-lactam antibiotics, it ability to interfere with PBP-mediated cell wall synthesis ultimately leads to cell lysis. Lysis is mediated by bacterial cell wall autolytic enzymes (i.e., autolysins). The relationship between PBPs and autolysins is unclear, but it is possible that the beta-lactam antibiotic interferes with an autolysin inhibitor.      Antibiotic possesses activity against both Gram-positive and Gram-negative bacteria. The drug retains antibacterial activity in the presence of certain beta-lactamases, both penicillinase and cephalosporinase; however hydrolysis by other beta-lactamases, alteration of the PBP, and decreases permeability results in resistance to cefuroxime.

Indication of Antibiotics

For the treatment of many different types of bacterial infections such as bronchitis, sinusitis, tonsillitis, ear infections, skin infections, gonorrhea, and urinary tract infections.

  • Acute bacterial exacerbation of chronic bronchitis
  • Bacterial infections
  • Bloodstream infections
  • Bone and joint infections
  • Gonorrhea
  • Impetigo
  • Pneumonia
  • Urinary tract infection
  • Skin or soft tissue infection
  • Skin and structure infection
  • Septicemia
  • Meningitis
  • Joint infection
  • Osteomyelitis
  • Surgical prophylaxis
  • Tonsillitis/pharyngitis
  • Sinusitis
  • Intra abdominal infection
  • Appendicitis
  • Wound infection
  • Lower respiratory tract infection maxillary sinusitis
  • Otitis media bacterial
  • Skin and subcutaneous tissue bacterial infections
  • Pharyngitis
  • Bladder infection
  • Epiglottitis
  • Kidney infections
  • Otitis media
  • Peritonitis
  • Sepsis
  • Skin and structure /soft tissue  infection
  • Bacterial Infection
  • Bladder Infection
  • Acne
  • Bronchitis
  • Brucellosis
  • Bullous Pemphigoid
  • Chlamydia Infection
  • Ehrlichiosis
  • Epididymitis, Sexually Transmitted
  • Gonococcal Infection, Uncomplicated
  • Helicobacter Pylori Infection
  • Lyme Disease, Arthritis
  • Lyme Disease, Erythema Chronicum Migrans
  • Lyme Disease, Neurologic
  • Lymphogranuloma Venereum
  • Nongonococcal Urethritis
  • Ocular Rosacea
  • Ornithosis
  • Pelvic Inflammatory Disease
  • Pemphigoid
  • Pemphigus
  • Pneumonia
  • Psittacosis
  • Rheumatoid Arthritis
  • Rickettsial Infection
  • Syphilis, Early
  • Syphilis, Latent
  • Tertiary Syphilis
  • Upper Respiratory Tract Infection

Contra Indications of Antibiotics

  • History of severe hypersensitivity (e.g. anaphylactic reaction) to any other type of betalactam antibacterial agent (penicillins, monobactams and carbapenems).
  • Hemolytic anemia
  • Liver problems
  • Interstitial nephritis
  • Subacute cutaneous lupus erythematosus
  • Systemic lupus erythematosus
  • Antibiotic use should be avoided in pregnant or lactating women, and in children with developing teeth because they may result in permanent staining (dark yellow-gray teeth with a darker horizontal band that goes across the top and bottom rows of teeth), and possibly affect the growth of teeth and bones.
  • Usage during the first 12 weeks of pregnancy does not appear to increase the risk of any major birth defects. There may be a small increased risk for minor birth defects such as an inguinal hernia, but the number of reports is too small to be sure if there actually is any risk.
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Side Effects of Antibiotics

The most common side effects 

More common

Rare

Drug Interactions of Antibiotic

Antibiotic may interact with following drugs, suppliments, & may change the efficacy of drugs

References

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