Saturday, October 21, 2023

COMMON TYPES OF ANTIBIOTICS AND THEIR MECHANISM OF ACTION

 

1. PENICILLINS: Penicillin is one of the oldest and most commonly used antibiotics in many countries because of it's effectiveness and affordability. It is effective against a wide range of bacterial infections and is often used to treat strep throat, pneumonia, and other respiratory infections. In the past before the coming of newer and more effective antibiotics, it was also one of the first lines in treatment of syphilis and gonorrheal infection.  Some of the examples of penicillins include but not limited to; Amoxicillin, Cloxacillin, Penicillin V, and Penicillin G.

Mechanism of action: Penicillin and derivatives are taken in a broad class of antibiotics known as Beta-lactam antibiotics; they work by inhibiting the synthesis and development of the bacterial cell wall.

Drawbacks: Although penicillin is still used in many countries due to it’s affordability and spectrum of activity, the on-going emergence of antimicrobial drug resistance limits their use in many scenarios. In addition, there are many individuals who develop allergic reactions to penicillin compared to new and safer antibiotics.  I already discussed penicillin and it's use in medicine in details and if you would like to read more about it you can follow the link below;  Use of penicillin and it's derivatives in clinical medicine.


2. FLOROQUINOLONES: Some of the drugs in this sub class of antibiotics include; Ciprofloxacin, Levofloxacin among others. Ciprofloxacin which is one of the most commonly available and prescribed, is a powerful antibiotic that is effective against a wide range of bacteria. It is often used to treat urinary tract infections, respiratory infections, and skin infections.

Mechanism of action: These drugs produce their effects by interfering with the DNA replication process and we shall therefore collectively term them; DNA synthesis inhibitors or in other wards, antimetabolites.  I made a detailed discussion on the pharmacology of this class of drugs and you can read more about the from the link below; Fluroquinolones and their use in clinical medicine.


3. TETRACYCLINES: Some of the drugs in this sub class of antibiotics include; Tetracycline, Oxytetracycline, Doxycycline and others. Doxycycline one of the most common, is an antibiotic that is used to treat a variety of bacterial infections, including acne, respiratory infections, and sexually transmitted diseases.


Mechanism of action:  These drugs act by inhibiting the process of protein synthesis in the bacterial cell.

Drawbacks: Because of their spectrum of activity which is broad, irrational use of these drugs can read to clearance of part of the human microbiome, something that can lead to opportunistic infection and super infections or even rendering other antibiotics ineffective. 

Their use is known to cause development of pseudomembranous colitis by Clostridium deficile and some fungal manifestations for that purpose. They are also discouraged from usage in young children due to their teeth discoloration effects and may lead to borne development problems.


4. MACROLIDES: In this class of antibiotics we have examples such as Azithromycin, Erythromycin and Clarithromycin. Azithromycin one of the most common is often used to treat respiratory infections, skin infections, and sexually transmitted diseases. The dosage and formulation of Azithromycin allows good compliance because of a three days regimen and a single tablet daily.  I discussed Azithromycin in a separate discussion in details you can read more about it from the link below;  Use of Azithromycin in clinical medicine.


5. VANCOMYCIN: Vancomycin is a glycopeptide antibiotic that is used to treat serious bacterial infections, including sepsis and endocarditis. Although it’s self is not a beta lactam antibiotic like penicillin and cephalosporines, it shares the mechanism of action with them; Inhibits the synthesis and development of the bacterial cell wall.


6. METRONIDAZOLE - Metronidazole is an antibiotic that is effective against a wide range of bacterial and parasitic infections, including vaginal infections, skin infections, and gastrointestinal infections. In brief we shall say; it is both antibacterial and antiprotozoal and therefore can be used as a prophylaxis for bacteremia and treatment of amebiasis. It is one of the most effective antibiotics against Entamoeba histolitica.

Mechanism of action: Metronidazole when used against protozoa, is DNA synthesis inhibitor and therefore we can say; it is an antimetabolite. In bacteria it acts as a proton sink, depriving the bacteria cell of oxidative equivalents

Drawbacks: Metronidazole have several side effects including but not limited to; Nausea and vomiting, a metallic taste, and it also has a disulfiram-like effect when taken together with alcohol.  I discussed about Metronidazole alone and it's use in details you can read about it from  here;  Use of metronidazole in clinical medicine.


7. SALFONAMIDES: Some of the most common examples of sulfonamides include; sulfamethoxazole and salfadoxine.  These drugs are frequently combined with non-salfonamide molecules with which they share some mechanism of action including but not limited to; Pyrimethamine and Trimethoprim.  Such combinations has greater synergistic effects and they can be used in treatment of a wide range of infections.


Trimethoprim-sulfamethoxazole, is one of such combination antibiotic that is often used to treat urinary tract infections, respiratory infections, and gastrointestinal infections.  This combination has been used widely in immunocompromised and HIV/AIDS patients for prophylactic prevention of opportunistic infections especially related to protozoa.  

The other common application of such combinations is the use of a combination of Pyrimethamine and salfadoxine in brand names like "Fansidar", one of the current malarial prophylaxis therapy in pregnant mothers.  I have recently discussed more about sulfonamides and you can read about them from  the link below; Sulfonamides and their use in clinical medicine

In our next discussion, I will be looking at the rest of the antibiotic classes I have not discussed briefly here including but not limited to; Cephalosporines such as Ceftrioxone, Carbapems such as Imepenem, Rifamycins such as Rifampicin and Rifampin and many others.  You can also feel free to subscribe to my YouTube channel where I discuss some of these pharmacotherapy from the link below;  Mega Mover Empire on YouTube.


RELATED;

1.  PNEUMONIA

2.  ANTIMICROBIAL DRUG RESISTANCE

3.  THE ORIGIN OF ALLERGIC REACTIONS IN THE HUMAN BODY

4.  PHARMACOLOGY OF PENICILLIN AND IT'S DERIVATIVES

5.  FLOROQUINOLONES AND THEIR USE IN CLINICAL MEDICINE

6.  THE HUMAN MICROBIOME

7.  USE OF AZITHROMYCIN IN CLINICAL MEDICINE

8.  USE OF METRONIDAZOLE IN CLINICAL MEDICINE

REFERENCES

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