II. Definitions
- Antibiotic
- Substances that selectively kill or inhibit Microorganisms
- Targets specific to Microbes include Bacterial cell walls, cell membrane, and 30S or 50S ribosomal subunits
- Most Antibiotics are either naturally produced by Microorganisms, or their synthetic derivatives
- Bacteriocidal Antibiotic
- Bacteriocidal Antibiotics kill Bacteria
- Bacteriostatic Antibiotic
- Bacteriostatic Antibiotics inhibit Bacterial proliferation and spread, but do not kill the Bacteria
- Often works in concert with the Immune System, which subsequently kills Bacteria
- Minimum Inhibitory Concentration (MIC)
- Minimum concentration of an Antibiotic in a culture medium that will suppress Bacterial growth
- MIC cutoffs vary by organism and by Antibiotic, and are typically categorized as susceptible, intermediate or resistant
- One drug's lower MIC values than another drug, does not imply greater efficacy
- (2024) Presc Lett 31(1): 2-3
- Minimum Bactericidal Concentration (MBC)
III. Mechanism: Bacterial Cell Wall Inhibitors (Beta Lactams)
-
General: Beta Lactam
- Transpeptidase cross-links peptidoglycan mesh in the synthesis of the Bacterial cell wall
- Beta-Lactam's inhibition of Transpeptidase results in lysis and death of the Bacterial cell
- Beta-Lactams are inactivated by the enzyme Beta-Lactamase
- Beta-Lactamase is produced by beta-lactam resistant Bacteria
- Beta-Lactamase inhibitors have been developed to counter Beta Lactam resistance
- Amoxicillin-clavulanic acid (Augmentin)
- Ampicillin-Sulbactam (Unasyn)
- Ceftazidime-Avibactam
- Transpeptidase cross-links peptidoglycan mesh in the synthesis of the Bacterial cell wall
-
Penicillins
- Natural Penicillins (e.g. Penicillin V) and semisynthetic Penicillins (e.g. Benzathine Penicillin)
- Cover Streptococci and Anaerobes
- Penicillinase-Resistant Semisynthetic Penicillin (e.g. Dicloxacillin, Nafcillin)
- Cover streptococci and MSSA (Methicillin-Sensitive Staphylococcus Aureus)
- Aminopenicillins (e.g. Amoxicillin, Augmentin)
- Cover streptococci and Gram Negative Bacteria
- Extended Spectrum Penicillin (e.g. Piperacillin Tazobactam)
- Cover streptococci, Gram Negatives and Pseudomonas
- Natural Penicillins (e.g. Penicillin V) and semisynthetic Penicillins (e.g. Benzathine Penicillin)
-
Cephalosporins
- First Generation Cephalosporins (Cephalexin, Cefazolin)
- Covers Gram Positive Cocci (Streptococcus and MSSA), EKP Gram Negative Bacteria
- Second Generation Broad-spectrum Cephalosporins (e.g. Cefuroxime )
- Second Generation Anti-anaerobe Cephalosporins (e.g. Cefotetan, Cefoxitin)
- Covers Gram Positives, Gram Negatives, Bacteroides fragilis
- Third Generation Broad-Spectrum Cephalosporins (e.g. Ceftriaxone, Cefixime, Cefdinir)
- Covers Gram Positive Cocci, EKP and ESP Gram Negative Bacteria
- Third Generation Anti-Pseudomonal Cephalosporins (e.g. Ceftazidime)
- Covers EKP and ESP Gram Negative Bacteria, Pseudomonas
- Poor Gram Positive Cocci coverage, and no Coccobacilli coverage
- Fourth Generation Cephalosporins (e.g. Cefepime)
- Adds to broad spectrum third generation (broad spectrum Gram-positive and Gram-negative organisms)
- Additionally covers Beta-Lactamase resistant organisms and Pseudomonas
- Fifth Generation Cephalosporins (e.g. Ceftaroline)
- Adds to broad spectrum third generation (broad spectrum Gram-positive and Gram-negative organisms)
- Covers Pseudomonas and MRSA (Methicillin Resistant Staphylococcus Aureus)
- First Generation Cephalosporins (Cephalexin, Cefazolin)
- Other Bacterial Cell Wall Inhibitors
- Carbapenems (e.g. Meropenem, Ertapenem)
- Monolactams (e.g. Aztreonam)
- Cover Gram Negative aerobic Bacteriaa
- Lipopeptides (e.g. Daptomycin)
- Covers MRSA, Streptococcal Species, Vancomycin Sensitive Enterococcus
IV. Mechanism: DNA Inhibitors (Antimetabolites)
-
Fluoroquinolone
- First Generation Quinolones (Nalidixic Acid)
- Gram Negative Rod efficacy (no Pseudomonas coverage)
-
Second Generation Quinolones (e.g. Ciprofloxacin )
- Covers Aerobic Gram Negative Rods (including Pseudomonas), and some Gram Positive coverage
-
Third Generation Quinolones (e.g. Levofloxacin)
- Covers Gram Negative Rods, with greater Gram Positive Cocci coverage
-
Fourth Generation Quinolones (e.g. Trovafloxacin)
- Covers Gram Negative Rods, Gram Positive Cocci and Anaerobes
- First Generation Quinolones (Nalidixic Acid)
-
Sulfonamides (Inhibit DNA, as well as RNA and Protein synthesis)
- Trimethoprim Sulfamethoxazole (Bactrim, Septra)
- Covers enteric Gram Negative Bacteria (Urinary Tract Infections) and some Gram Positive organisms
- Also used in PCP Pneumonia treatment and prophylaxis (AIDS) and MRSA Skin Infections
- Other Sulfonamides
- Sulfadiazine (Toxoplasmosis prophylaxis)
- Sulfisoxazole (UTI prophylaxis)
- Trimethoprim Sulfamethoxazole (Bactrim, Septra)
- Other DNA Inhibitors
- Metronidazole
- Covers Anaerobes (e.g. Bacteroides, Peptococcus, Clostridioides difficile)
- Nitrofurantoin
- Covers many urinary pathogens (but NOT Pseudomonas, Klebsiella, Proteus Serratia or Acinetobacter)
- Rifamycin (e.g. Rifampin)
- Covers Mycobacterium (esp. Tuberculosis as part of multi-drug regimen)
- Metronidazole
V. Mechanism: Protein Synthesis Inhibitors (at 30s or 50s ribosome)
-
Macrolides
- Erythromycin
- Covers Bacteria without cell walls (Mycoplasma, Legionella, Chlamydia)
- Covers Aerobic Bacteria, Gram Positive Aerobes, Gram Negative Aerobes (except Campylobacter, Pasteurella)
- Extended Spectrum Macrolides (e.g. Azithromycin, Clarithromycin)
- Coverage includes organisms covered by Erythromycin
- Cover Chlamydia Trachomatis, Non-tuberculous Mycobacteria, Helicobacter and some respiratory infections
- Fidaxomicin (Dificid)
- Narrow spectrum Antibiotic (C. difficile, Staphylococcus, Enterococcus)
- Minimal systemic absorption when taken orally
- Erythromycin
-
Tetracyclines (e.g. Doxycycline)
- Cover MRSA, Helicobacter Pylori, Tick-borne illness (e.g. Lyme Disease), STDs (e.g. Chlamydia Trachomatis)
-
Aminoglycosides (e.g. Gentamicin)
- Cover aerobic and facultative Gram Negative Rods (including Pseudomonas)
- NO anaerobic activity
- Other Protein Synthesis Inhibitors
- Chloramphenicol
- Bacteriostatic activity against Gram Positives, Gram Negatives and Anaerobic Bacteria
- Linezolid
- Bacteriostatic against VRE, MRSA and bactertiocidal against Streptococcus species
- Clindamycin
- Covers Anaerobes and Gram Positive Bacteria (including MRSA coverage, but with high risk of resistance)
- Chloramphenicol
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Related Studies
Definition (HL7V3.0) | <p><b>Description:</b>Non-person living subject used as antibiotic.</p><p><b>Examples:</b>Bacteriophage, is a virus that infects bacteria.</p> |
Definition (MEDLINEPLUS) |
Antibiotics are powerful medicines that fight bacterial infections. Used properly, antibiotics can save lives. They either kill bacteria or keep them from reproducing. Your body's natural defenses can usually take it from there. Antibiotics do not fight infections caused by viruses, such as
If a virus is making you sick, taking antibiotics may do more harm than good. Each time you take antibiotics, you increase the chances that bacteria in your body will be able to resist them. Later, you could get or spread an infection that those antibiotics cannot cure. Methicillin-resistant Staphylococcus aureus (MRSA) causes infections that are resistant to several common antibiotics. When you take antibiotics, follow the directions carefully. It is important to finish your medicine even if you feel better. If you stop treatment too soon, some bacteria may survive and re-infect you. Do not save antibiotics for later or use someone else's prescription. Centers for Disease Control and Prevention |
Definition (NCI) | Substances naturally produced by microorganisms or their derivatives that selectively target microorganisms not humans. Antibiotics kill or inhibit the growth of microorganisms by targeting components of the microbial cell absent from human cells, including bacterial cell walls, cell membrane, and 30S or 50S ribosomal subunits. These substances are used in the treatment of bacterial and other microbial infections. |
Definition (NCI_NCI-GLOSS) | A substance that kills microorganisms such as bacteria or mold, or stops them from growing and causing disease. |
Definition (MSH) | Substances produced by microorganisms that can inhibit or suppress the growth of other microorganisms. |
Definition (CSP) | substances produced by microorganisms or biomimetics that can inhibit or suppress the growth of other microorganisms; frequently used without reference to the microbial origins of the original substance. |
Concepts | Antibiotic (T195) |
MSH | D000900 |
SnomedCT | 41000005, 255631004 |
HL7 | ANTIBIOT |
LNC | LP31426-7 |
French | Médicaments antibiotiques, Agents antibiotiques, Antibiotiques |
Czech | antibiotika |
Portuguese | Antibióticos |
Spanish | Antibióticos, antibiótico (sustancia), antibiótico (concepto no activo), antibiótico (producto), antibiótico |
German | Antibiotika |
Italian | Antibiotici |
English | antibiotic products, antibiotics, Antibiotic (substance), Antibiotic, Antibiotic (product), antibiotic, drug, antibiotic, Antibiotic, NOS, Antibiotic Agents, Antibiotic Drugs, Antibiotics |
Ontology: Anti-Bacterial Agents (C0279516)
Definition (NCI_NCI-GLOSS) | A substance that kills bacteria or stops them from growing and causing disease. |
Definition (NCI) | A family of substances capable of destroying or inhibiting the growth of bacteria. |
Definition (MSH) | Substances that reduce the growth or reproduction of BACTERIA. |
Definition (CSP) | substance that destroys bacteria or prevents their growth or replication. |
Concepts | Antibiotic (T195) |
MSH | D000900 |
SnomedCT | 28320003, 283019008, 346325008, 419241000 |
Spanish | agente antibacteriano (sustancia), agente antibacteriano, Antibacterianos, Agentes Antibacterianos, Fármacos Antibióticos, Medicamentos Antibióticos, Fármacos Antibacterianos, drogas antibacterianas (producto), drogas antibacterianas (sustancia), drogas antibacterianas, fármaco antibacteriano (producto), fármaco antibacteriano |
French | Antibactériens, Anti-bactériens, Médicaments antibactériens, Agents antibactériens |
Swedish | Antibakteriella medel |
English | ANTIBACTERIAL AGENTS, antibacterial agents (medication), antibacterial agents, Antibacterial Agent, Antibacterial Agent [TC], antibacterial, antibacterials, antibacterial drug, anti-bacterial agents, antibacterial drugs, Antibacterial drugs (substance), Agents, Antibacterial, Anti Bacterial Agents, Antibacterial Agents, Agents, Anti-Bacterial, Antibacterial drugs, Antibacterial drugs (product), antibacterial agent, Antibacterial, NOS, Anti-Bacterial Agents, Antibacterials, Antibacterial, Antibacterial agent (substance), Antibacterial agent |
Czech | antibakteriální látky |
Finnish | Bakteerilääkkeet |
Russian | TETRATSIKLINOVYE ANTIBIOTIKI, ANTIBIOTIKI AMINOGLIKOZIDNYE, ANTIBIOTIKI PEPTIDNYE, ANTIBIOTIKI GLIKOZIDNYE, AMINOGLIKOZIDNYE ANTIBIOTIKI, ANTIBIOTIKI MAKROLIDNYE, ANTIMIKOBAKTERIAL'NYE SREDSTVA, ANTIBIOTIKI BETA-LAKTAMNYE, ANTIBIOTIKI LAKTAMNYE, GLIKOZIDNYE ANTIBIOTIKI, MAKROLIDNYE ANTIBIOTIKI, PEPTIDNYE ANTIBIOTIKI, ANTIBIOTIKI, ANTIBIOTIKI GLIKOPEPTIDNYE, ANTIBAKTERIAL'NYE SREDSTVA, ANTIBIOTIKI TETRATSIKLINOVYE, BETA-LAKTAMNYE ANTIBIOTIKI, АМИНОГЛИКОЗИДНЫЕ АНТИБИОТИКИ, АНТИБАКТЕРИАЛЬНЫЕ СРЕДСТВА, АНТИБИОТИКИ, АНТИБИОТИКИ АМИНОГЛИКОЗИДНЫЕ, АНТИБИОТИКИ ГЛИКОЗИДНЫЕ, АНТИБИОТИКИ МАКРОЛИДНЫЕ, АНТИБИОТИКИ ТЕТРАЦИКЛИНОВЫЕ, АНТИМИКОБАКТЕРИАЛЬНЫЕ СРЕДСТВА, ГЛИКОЗИДНЫЕ АНТИБИОТИКИ, МАКРОЛИДНЫЕ АНТИБИОТИКИ, ТЕТРАЦИКЛИНОВЫЕ АНТИБИОТИКИ, АНТИБИОТИКИ БЕТА-ЛАКТАМНЫЕ, АНТИБИОТИКИ ЛАКТАМНЫЕ, БЕТА-ЛАКТАМНЫЕ АНТИБИОТИКИ, АНТИБИОТИКИ ГЛИКОПЕПТИДНЫЕ, АНТИБИОТИКИ ПЕПТИДНЫЕ, ПЕПТИДНЫЕ АНТИБИОТИКИ |
Japanese | 抗細菌剤, 抗生物質, 抗生剤, 抗生物質-ペプチド系, ペプチド系抗生物質 |
Croatian | ANTIBAKTERIJSKI LIJEKOVI |
Polish | Leki przeciwbakteryjne, Antybiotyki, Środki przeciwbakteryjne |
Portuguese | Antibacterianos, Fármacos Antibióticos, Medicamentos Antibióticos, Fármacos Antibacterianos, Agentes Antibacterianos |
Norwegian | Antibiotika |
German | Antibakterielle Mittel |
Italian | Agenti antibatterici |
Ontology: antibiotic with bacteriostatic action (C0280050)
Concepts | Pharmacologic Substance (T121) |
English | antibiotic with bacteriostatic action |
Ontology: Minimum bactericidal concentration (C0427975)
Concepts | Laboratory or Test Result (T034) |
SnomedCT | 250478006, 385465001 |
English | MBC - Minimum bactericidal concentration, MBC-Min bactericidal concentr, Min bactericidal concentration, Minimum bactericidal concentration, Minimum bactericidal concentration (procedure), Minimum bactericidal concentration finding (finding), Minimum bactericidal concentration finding |
Spanish | concentración bactericida mínima - hallazgo (hallazgo), concentración bactericida mínima - hallazgo |
Ontology: Minimum Inhibitory Concentration measurement (C0427978)
Definition (HL7V3.0) | <p>Testing to measure the minimum concentration of the antibacterial agent in a given culture medium below which bacterial growth is not inhibited.</p> |
Concepts | Laboratory Procedure (T059) |
MSH | D008826 |
SnomedCT | 39334004 |
HL7 | 0272 |
LNC | LP6389-3 |
English | Concentration, Minimum Inhibitory, Concentrations, Minimum Inhibitory, Inhibitory Concentration, Minimum, Inhibitory Concentrations, Minimum, Minimum Inhibitory Concentrations, MIC, minimum inhibitory concentration, Antibiotic sensitivity, minimum inhibitory concentration (MIC), MIC - Minimum inhibitory concentration, Minimum inhibitory concentration, Broth microdilution susceptibility test (procedure), Broth microdilution susceptibility test, MIC susceptibility test, Broth microdilution susceptibility test, NOS, MIC susceptibility test, NOS, Minimum Inhibitory Concentration measurement, Minimum Inhibitory Concentration |
French | CMI (Concentration Minimale Inhibitrice), Concentration minimale inhibitrice, CIM (Concentration Inhibitrice Minimale), Concentration inhibitrice minimale |
Japanese | サイショウハツイクソシノウド, 最小発育阻止濃度 |
Portuguese | Concentração Inibitória Mínima, Concentração inibidora mínima |
Spanish | Concentración Inhibitoria Mínima, antibiograma CIM, antibiograma, concentración inhibitoria mínima (CIM) (procedimiento), antibiograma, concentración inhibitoria mínima (CIM), prueba de sensibilidad en caldo de microdilución antibiótica, Concentración mínima inhibitoria |
German | Minimale Hemmkonzentration, minimale Hemmkonzentration |
Italian | Concentrazione minima inibitoria |
Czech | Minimální inhibiční koncentrace |
Hungarian | Minimum inhibitoros koncentráció (MIC) |
Norwegian | Minimal inhibitorisk konsentrasjon, MIC |
Dutch | minimale inhiberende concentratie, Minimum-inhibitieconcentratie |
Ontology: Bacteriocidal Agents (C1258056)
Definition (MSH) | Substances that kill BACTERIA. |
Concepts | Antibiotic (T195) |
MSH | D000900 |
French | Médicaments bactéricides, Bactéricides, Agents bactéricides |
Czech | baktericidní látky |
German | Bakterizide Mittel |
Italian | Battericidi, Agenti battericidi |
English | Agents, Bacteriocidal, Bacteriocides, Bacteriocidal Agents |