Antibiotics – drug classes and mechanisms

almostadoctor.co.uk/encyclopedia/antibiotics-drug-classes-and-mechanisms

Dr Tom Leach

There are many classes of antibiotics. It is useful to know at least a handful of antibiotics, and what
they are useful for. Below we attempt to summarise the main types of antibiotics, their mechanisms
and their common uses.

Antibiotic Classification and Mechanisms – Click for full size

1/4
Gram Positive and Gram Negative Bacteria – Click for full size

2/4
Drugs used in TB

Rifamycins Rifamycin, Cidal Nausea, anorexia, Also used in Widespread Y ? ? ?

Inhibits DNA rifabutin pseudomembranous mycobacterial – develops
transcription colitis, infections – rapidly
hepatotoxicity, these most
orange colouration commonly
of excreted bodily occur in those
fluids, toxicity with HIV.
syndromes, drug Resistance
interactions prevents more
widespread
use

Isoniazid Isoniazid Cidal Nausea, vomiting, Bactericidal on Occurs N N N ?

Inhibits / constipation, dividing rapidly if
synthesis of static peripheral organisms, used alone
cell wall neuropathy, static on
hepatitis, SLE-like- resting. Only
symptoms effective
against
myobacteria

Pyrazinamide pyrazinamide Cidal Hepatotoxicity, Only effective Occurs N N N ?

Lowers nausea, vomiting, against rapidly if
intracellular arthralgia, myobacteria used alone
pH, sideroblastic
disrupting anaemia
synthesis of
fatty acids

Ethambutol Ethambutol Static Optic neuritis – Only effective Uncommon N N N

Interferes resulting in against
with cell wall red/green myobacteria
synthesis colourblindness.
neuritis

Mycobacteria
This is its own genus of bacteria (like G+ or G-). The group include TB and leprosy. They are acid fast.
They are also aerobic.
Acid fast
This basically means the organisms are difficult to stain using normal staining techniques. The name
3/4
refers to the fact they can’t be stained by normal acid (ethanol) staining techniques. These bacteria are
often particularly difficult to culture and identify; e.g. TB takes around 6-8 weeks.
‘Sore Throat’
If you are going to give antibiotics for a suspected tonsillitis, don’t give amoxicillin. If the infection is
glandular fever, then the amoxicillin can cause a widespread skin reaction. The antibiotics of choice for
tonsillitis is penicillin 500mg QID PO.

Related Articles
Common Drug Interactions
Renin Inhibitors
Angiotensin II Receptor Blockers (ARBs)
Memantine
Propofol

4/4