Fluoroquinolones (Oral, Cannot give with

divalent cations)
Broad spectrum Enter bacterium via porins
Inhibit two bacterial enzymes, DNA gyrase
(topoisomerase II) [DNA can't uncoil] and
topoisomerase IV damage to bacterial
DNA and bacterial cell death (bactericidal)
Respiratory Fluoroquinolones (Levofloxacin,
Moxifloxacin, and Gemifloxacin excellent
activity against S. Pneumoniae, H. I nfluenzae,
and M. Catarrhalis used to treat pneumonia
for inpatients when 1
st
line agents failed
o 1
st
Gen = Nalidixic Acid(Quinolones)
Treat uncomplicated UTIs
o 2
nd
Gen = Ciprofloxacin Treat travelers
diarrhea (MCC E. Coli), P. Aeruginosa
(CF), Meningitis Prophylaxis
o 3
rd
Gen = Levofloxacin Treat Prostitis
(E. Coli), STDs (not syphilis), Skin
Infections, Acute Sinusitis, Bronchitis,
TB, CAP
o 4
th
Gen = Moxifloxacinand Gemifloxacin
CAP (respiratory fluoroquinolones)
Sulfonamides(Oral or Topical)
Sulfacetamide, Sulfadiazine, Sulfadoxine,
Sulfamethoxazole(SMX), Sulfasalazine,
and Sulfisoxazole
Structural analogs of PABA I nhibit
dihydropteroatesynthase inhibiting
bacterial folic acid synthesis
Bacteriostatic against Gram +ve and -ve
bugs Uses
o Infrequently used single agents
(resistance)
o Topical agents ocular, burn
infections
o Oral agents simple UTIs
Sulfasalazine(oral) = ulcerative colitis,
enteritis, IBD
Daptomycin (IV)
Binds to cell membrane via Ca
2+
- dependent insertion
of lipid tail K
+
efflux cell membrane
depolarization cell death (Bactericidal)
o Used for MDR bacteria Effective against
resistant Gram +ve organisms (i.e., MRSA
(ORSA), enterococci, VRE and VRSA)
o Inactive against Gram -ve bacteria
o Not effective in treatment of pneumonia
o Tx complicated skin/structure infection due to S.
Aureus and severe infections caused by MRSA
or VRE
Polymyxin B (Topical)
aka Neosporin
Binds to LPS Blocks to outer and
inner membrane
o Bactericidal for Gram -ve
Cell
Membrane
Synthesis
Inhibitors
Daptomycin
Polymyxin B
Nitrofurantoins
Bacteriostatic and bactericidal depending on bug
Damages bacterial DNA Active against many Gram +ve and -ve bugs
Reduction of nitrofurantoinby bacteria in urine leads to reactive
intermediates formation subsequently damage bacterial DNA
o Urinary antiseptic that is rapidly secreted into the urine and acts there to
suppress bacteriuria. It has little or no systemic antibacterial effect.
Trimethoprim(TMX)
Structure similar to folic acid Potent
inhibitor of bacterial dihydrofolate
reductase Inhibits purine, pyrimidine,
and AA synthesis
Bacteriostatic against Gram +ve & -ve
bugs
o UTIs (Not DOC)
o Bacterial prostatitis
o Bacterial vaginitis
Co-trimoxazole(Oral or IV)
Trimethoprim+ sulfamethoxazole
combo
Synergistic inhibition of sequential
steps in THF acid synthesis
Bactericidal
o DOC for Uncomplicated UTIs,
PCP, Nocardiosis, Toxoplasmosis
o Respiratory, Ear, Sinus infections
(H. I nfluenzae, M. Catarrhalis)
Protein Synthesis 30S
Subunit Inhibitors
Tetracyclines
Aminoglycosides
Glycylcylines
Cell Wall
Synthesis
Inhibitors
-Lactam
Antibiotics
o Penicillins
o Cephalosporins
o Carbapenems
o Monobactams
Vancomycin
Bacitracin
Fosfomycin
Ethambutol
Ethionamide
Isoniazid
Metronidazole(Oral, IV, Rectal, or Topical)
Imidazole derivative with activity against protozoa and bacteria
Forms free radical toxic in the bacterial cell that damage DNA
Activity dependent on anaerobic conditions undergoes reductive
bioactivation of its nitro group by ferredoxin (present in anaerobic
parasites) forms reactivecytotoxic productsthat interfere with
nucleic acid synthesis
o DOC for C. Difficileinfections
o Anaerobic or mixed intra-abdominal infections
o Vaginitis (trichomonasand bacterial vaginosis, G. vaginalis)
o Brain abscesses
o H. Pylori eradication (in combination)
Translation
Inhibitor
Fidaxomicin
Fidaxomicin
Inhibits bacterial protein synthesis by binding to the
sigma subunit of RNA polymerase (inhibits enzyme)
Narrow-spectrum, macrocyclic antibiotic Treatment
of C. DifficileColitis (in adults, not in kids)
Anti-Metabolites
(Folic Acid
Metabolism Inhibitors)
Sulfonamides
Trimethoprim
Co-trimoxazole
Dapsone
RNA Synthesis
Inhibitors
Rifamycin
Rifampin, Rifabutin,
and Rifapentine
Protein Synthesis
50S Subunit
Inhibitors
Chloramphenicol
Clindamycin
Erythromycin
(Macrolides)
Linezolid
Streptogramins
Fidaxomicin
Anti-Pseudomonal
Penicillins
o Carbenicillin
o Piperacillin
o Ticarcillin
Extended-Spectrum
Penicillins
o Amoxicillin
o Ampicillin
1
st
Gen. Cephalosporins
o Cefazolin
o Cephalexin
2
nd
Gen. Cephalosporins
o Cefaclor
o Cefamandole
o Cefoxitin
o Cefotetan
3
rd
Gen. Cephalosporins
o Cefotaxime
o Ceftriaxone
o Cefoperazone
o Ceftazidime
o Cefixime
4
th
Gen. Cephalosporins
o Cefepime
DNA Synthesis
Inhibitors
Fluoroquinolones
Metronidazole
Nitrofurantoin
Clofazimine
Natural Penicillins
o Penicillin G
o Penicillin V
Anti-Staphylococcal
Penicillins
o Methicillin
o Oxacillin
o Nafcillin
o Dicloxacillin
Respiratory Penicillins
o Penicillin G
Benzathine
o Penicillin G Procaine