Antibiotics
Antibiotics
Antibiotics
Chemotherapy
• The use of drugs to treat a disease
Figure 20.8
Semisynthetic Penicillins
• Penicilinase-resistant penicillins
• Carbapenems: very broad spectrum
• Monobactam: Gram negative
• Extended-spectrum penicillins
• Penicillins + -lactamase inhibitors
Other Inhibitors of Cell Wall Synthesis
• Cephalosporins
– 2nd, 3rd, and 4th
generations more
effective against
gram-negatives
Figure 20.9
Other Inhibitors of Cell Wall Synthesis
• Polypeptide antibiotics
– Bacitracin
• Topical application
• Against gram-positives
– Vancomycin
• Glycopeptide
• Important "last line" against antibiotic resistant S. aureus
Other Inhibitors of Cell Wall
Synthesis
Antibiotics
effective against
Mycobacteria:
interfere with
mycolic acid
synthesis or
incorporation
Isoniazid (INH)
Ethambutol
Inhibitors of Protein Synthesis
• Broad spectrum, toxicity problems
• Examples
– Chloramphenicol (bone marrow)
– Aminoglycosides: Streptomycin, neomycin,
gentamycin (hearing, kidneys)
– Tetracyclines (Rickettsias & Chlamydia; GI
tract)
– Macrolides: Erythromycin (gram +, used in
children)
Injury to the Plasma Membrane
Figure 5.7
Antimicrobial Resistance
• Relative or complete lack of effect
of antimicrobial against a previously
susceptible microbe
• Increase in MIC
Mechanisms of Antibiotic
Resistance
• Antisense agents
– Complementary DNA or peptide nucleic acids that
binds to a pathogen's virulence gene(s) and prevents
transcription
Antifungal Drugs
• Fungi are
eukaryotes
• Have unique
sterols in their cell
walls
• Pathogenic fungi
are often outside
the body
Antiviral Drugs
• Viruses are composed of nucleic acid,
protein capsid, and host membrane
containing virus proteins
• Viruses live inside host cells and use many
host enzymes
• Some viruses have unique enzymes for
DNA/RNA synthesis or protein cutting in
virus assembly
Antiviral Drugs
Nucleoside and Nucleotide Analogs
Figure 20.16a
Analogs Block DNA Synthesis
Figure 20.16b, c
Antiviral Drugs
Enzyme Inhibitors
• Inhibit assembly
– Indinavir (HIV)
• Inhibit attachment
– Zanamivir (Influenza)
• Inhibit uncoating
– Amantadine (Influenza)
Antiviral Drugs
Enzyme Inhibitors
• Protozoa are
eukaryotic cells
• Many drugs are
experimental and
their mode of action
is unknown
Antihelminthic Drugs
• Helminths are
macroscopic
multicellular
eukaryotic
organisms:
tapeworms,
roundworms,
pinworms,
hookworms
Antihelminthic Drugs
• Prevent ATP generation (Tapeworms)
• Alters membrane permeability (Flatworms)
• Neuromuscular block (Intestinal roundworms)
• Inhibits nutrient absorption (Intestinal
roundworms)
• Paralyzes worm (Intestinal roundworms)
Measuring Antimicrobial Sensitivity
• E Test
• MIC: Minimal
inhibitory
concentration