R

β-Lactam Ring

Penicillin Cephalosporin
β-Lactams
N
O

OH
CH3
C
S R
CH3H
SO3H

Monobactam Carbapenem

Carbacephem
 Extracellular

β-Lactams
• Penicillin
Cell Wall
Synthesis

DNA mRNA
Pyrimidines 30S
& Purines
Synthesis 50S

Intracellular
Penicillin

Penicillin

Penicillinase- Expanded Spectrum Penicillin+ β-

Natural Penicillin Aminopenicillins
resistant Penicillin Penicillin lactamase Inhibitors

Ampicillin-like Co-amoxiclav
Benzylpenicillin Penicillin V Flucloxacillin Piperacillin
Agents

Amoxicillin Clavulanate
Penicillin Distribution

Penicillin V
Aminopenicillins
Flucloxacillin

Benzylpenicillin
Piperacillin

Excretion
 Extracellular

β-Lactams
• Penicillin
• Cephalosporins Cell Wall
Synthesis

Pyrimidines DNA mRNA 30S

& Purines
Synthesis 50S

Intracellular
Cephalosporins

Cephalosporin

Cephalexin Cefazolin Cefaclor Ceftriaxone Cefepime

Cephalosporins Distribution

Cephalexin
Cefaclor

Ceftriaxone
Cefazoline
Cefepime

Excretion
Cephalosporins

Cephalosporin

Gram-Negative
Gram-Positive
 Extracellular

β-Lactams
• Penicillin
• Cephalosporins Cell Wall
• Monobactams Synthesis

Pyrimidines DNA mRNA 30S

& Purines
Synthesis 50S

Intracellular
Monobactams

CH3

SO3H

β-Lactam Ring

Monobactam
Monobactams

Monobactams

Aztreonam
 Extracellular

β-Lactams
• Penicillin
• Cephalosporins Cell Wall
• Monobactams Synthesis
• Carbapenems

Pyrimidines DNA mRNA 30S

& Purines
Synthesis 50S

Intracellular
Carbapenems

Gram-Positive

Aerobic Anaerobic

Gram-Negative
 Extracellular

β-Lactams
• Penicillin
• Cephalosporins Cell Wall
• Monobactams Synthesis
• Carbapenems
• Carbacephems

Pyrimidines DNA mRNA 30S

& Purines
Synthesis 50S

Intracellular
Carbacephems

Cephalosporin
Carbacephem
 Extracellular

β-Lactams Glycopeptides
• Penicillin
• Cephalosporins Cell Wall
• Monobactams Synthesis
• Carbapenems
• Carbacephems

Pyrimidines DNA mRNA 30S

& Purines
Synthesis 50S

Intracellular
Glycopeptides

Glycopeptides

Vancomycin Teicoplanin

MRSA
(Methicillin-Resistant
Staphylococcus aureus)
Glycopeptides Distribution

Vancomycin
(For pseudomembranous
Colitis)

Intravenous

Excretion Intraperitoneal
Glycopeptides

Glycopeptide- Staphylococcus aureus

resistant Enterococci
 Extracellular

β-Lactams Glycopeptides
• Penicillin
• Cephalosporins Cell Wall
• Monobactams Synthesis
• Carbapenems
• Carbacephems

Pyrimidines DNA mRNA 30S

& Purines
Synthesis 50S

Sulphonamides
Trimethoprim

Intracellular
Sulfonamides

Sulfonamides

Sulfadiazine Sulfamethoxazole
Sulfonamides Distribution

Sulfadiazine

Sulfamethoxazole

Metabolism

Excretion
 Extracellular

β-Lactams Glycopeptides
• Penicillin
• Cephalosporins Cell Wall
• Monobactams Synthesis
• Carbapenems
• Carbacephems

Fluoroquinolones 30S
Pyrimidines DNA mRNA
& Purines
Synthesis 50S

Sulphonamides
Trimethoprim

Intracellular
Quinolones

Fluoroquinolones

Ciprofloxacin Moxifloxacin Norfloxacin Levofloxacin Ofloxacin

Quinolones Distribution

Excretion
 Extracellular

β-Lactams Glycopeptides
• Penicillin
• Cephalosporins Cell Wall
• Monobactams Synthesis
• Carbapenems
• Carbacephems

Fluoroquinolones 30S
Pyrimidines DNA mRNA
& Purines
Synthesis 50S

Sulphonamides Metroniazole
Trimethoprim

Intracellular
Metronidazole Distribution

Metabolism

Excretion
 Extracellular

β-Lactams Glycopeptides
• Penicillin
• Cephalosporins Cell Wall
• Monobactams Synthesis
• Carbapenems
• Carbacephems Tetracycline

Fluoroquinolones 30S
Pyrimidines DNA mRNA
& Purines
Synthesis 50S

Sulphonamides Metroniazole
Trimethoprim

Intracellular
Tetracyclines

Tetracyclines

Doxycycline Minocycline Tigecycline

Tetracyclines Distribution

Doxycycline

Minocycline
Tigecycline
Minocycline

Excretion
 Extracellular

β-Lactams Glycopeptides
• Penicillin
• Cephalosporins Cell Wall
• Monobactams Synthesis
• Carbapenems Tetracycline
• Carbacephems Aminoglycosides

Fluoroquinolones 30S
Pyrimidines DNA mRNA
& Purines
Synthesis 50S

Sulphonamides Metroniazole
Trimethoprim

Intracellular
Aminoglycosides

Aminoglycosides

Gentamicin Amikacin Neomycin Streptomycin

Aminoglycosides Distribution

Gentamicin
Amikacin
Neomycin
Streptomycin

Vestibulocochlear
(8th Cranial Nerve)
Excretion
 Extracellular

β-Lactams Glycopeptides
• Penicillin
• Cephalosporins Cell Wall
• Monobactams Synthesis Tetracycline
• Carbapenems Aminoglycosides
• Carbacephems

Fluoroquinolones 30S
Pyrimidines DNA mRNA
& Purines
Synthesis 50S

Sulphonamides Metroniazole
Oxazolidinone
Trimethoprim

Intracellular
Oxazolidinone

Oxazolidinones

Linezolid
 Extracellular

β-Lactams Glycopeptides
• Penicillin
• Cephalosporins Cell Wall
• Monobactams Synthesis Tetracycline
• Carbapenems Aminoglycosides
• Carbacephems

Fluoroquinolones 30S
Pyrimidines DNA mRNA
& Purines
Synthesis 50S

Sulphonamides Metroniazole
Trimethoprim Oxazolidinone
Macrolide

Intracellular
Macrolides

Macrolides

Erythromycin Azithromycin Clarithromycin

Macrolides Distribution
Erythromycin
Azithromycin
Clarithromycin

Erythromycin
Azithromycin

Excretion
 Tetracycline
Aminoglycosides

Fluoroquinolones 30S
Pyrimidines DNA mRNA
& Purines
Synthesis 50S

Sulphonamides Metroniazole
Trimethoprim Oxazolidinone
Macrolide
Streptogramin

Intracellular
 Extracellular

β-Lactams Glycopeptides
• Penicillin
• Cephalosporins Cell Wall
• Monobactams Synthesis Tetracycline
• Carbapenems Aminoglycosides
• Carbacephems

Fluoroquinolones 30S
Pyrimidines DNA mRNA
& Purines
Synthesis 50S

Sulphonamides Metroniazole
Trimethoprim Oxazolidinone
Macrolide
Streptogramin

Intracellular
Streptogramins

Streptogramins

Pristinamycin

Quinopristin Dalfopristin
Streptogramins

Gram-Positive Bacteria
GRE (Glycopeptide Resistant Enterococci)

GISA (Glycopeptide-Intermediate S. aureus )

Daptomycin

Lipopeptide Antibiotic

Gram-Positive Bacteria

“SUPER BUG”
MRSA
(Methicillin-Resistant
Staphylococcus aureus)
Daptomycin

Daptomycin
Daptomycin

Daptomycin

Daptomycin

K+

K+

K+

K+
Daptomycin

Daptomycin

Daptomycin

K+

K+

K+

K+
Daptomycin

Daptomycin

Daptomycin

K+

K+ K+

K+
 Extracellular

β-Lactams Glycopeptides
• Penicillin
• Cephalosporins Cell Wall
• Monobactams Synthesis Tetracycline
• Carbapenems Aminoglycosides
• Carbacephems

Fluoroquinolones 30S
Pyrimidines DNA mRNA
& Purines
Synthesis 50S

Sulphonamides Metroniazole
Trimethoprim Oxazolidinone
Macrolide
Streptogramin

Intracellular
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