Drug Classes

1.
Drug Classes
2. Anti-infectives
3. Cephalosporins
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Cephalosporins
Written by C. Fookes, BPharm on Jul 20, 2018
What are Cephalosporins?

Cephalosporins are a large group of antibiotics derived from the
mold Acremonium (previously called Cephalosporium). Cephalosporins are
bactericidal (kill bacteria) and work in a similar way to penicillins. They bind to
and block the activity of enzymes responsible for making peptidoglycan, an
important component of the bacterial cell wall. They are called broad-spectrum
antibiotics because they are effective against a wide range of bacteria.
Since the first cephalosporin was discovered in 1945, scientists have been
improving the structure of cephalosporins to make them more effective against a
wider range of bacteria. Each time the structure changes, a new "generation" of
cephalosporins are made. So far there are five generations of cephalosporins. All
cephalosporins start with cef, ceph, or kef. Note that this classification system is
not used consistently from country to country.
What are cephalosporins used for?

Cephalosporins may be used to treat infections caused by susceptible bacteria,
such as:
 Bone infections
 Ear infections (eg, otitis media)
 Skin infections
 Upper respiratory tract infections
 Urinary tract infections.
Cephalosporins are not usually used as a first-choice antibiotic. They tend to be
reserved for use when other antibiotics (often penicillins) cannot be used.
What are the differences between

cephalosporins?
There are currently five “generations” of cephalosporins, with each generation
differing slightly in their antibacterial spectrum (ie, how effective they are at
killing certain types of bacteria). Within each generation, there are differences in
terms of administration (such as oral or intravenous administration), absorption,
excretion, and how long the activity of the cephalosporin lasts for in the body.
First generation cephalosporins
First generation cephalosporins refer to the first group of cephalosporins

discovered. Their optimum activity is against gram-positive bacteria such
as staphylococci and streptococci. They have little activity against gram-negative
bacteria.
Cephalexin and cefadroxil can be given by mouth, whereas cefazolin can only
be given by injection (IV/IM). There are also differences with regards to how
frequently the different first-generation cephalosporins need to be dosed.
Generic name Brand name examples
cefadroxil Duricef
cefazolin Ancef, Kefzol
cephadrine Discontinued
cephalexin Daxbia, Keflex
Second generation cephalosporins
Second-generation cephalosporins are more active against gram-negative

bacteria, with less activity against gram-positive bacteria.
cefotetan Cefotan
cefoxitin Mefoxin
cefprozil Cefzil
cefuroxime Ceftin, Zinacef
loracarbef Discontinued
Third generation cephalosporins
Third generation cephalosporins followed the second-generation cephalosporins.

No one third-generation cephalosporin treats all infectious disease scenarios.
Cefotaxime and ceftizoxime (discontinued) offer the best gram-positive

coverage out of all the third-generation agents; ceftazidime and cefoperazone
(discontinued) are unique in that they provide antipseudomonal coverage.
Ceftriaxone has a long half-life which allows for once daily dosing and may be
used for the treatment of gonorrhea, pelvic inflammatory disease, and
epididymo-orchitis. It is also an alternative to penicillins for
suspected meningitis.
All the third-generation cephalosporins except for cefoperazone (discontinued)

penetrate cerebrospinal fluid.
cefdinir Omnicef
cefditoren Spectracef
cefixime Suprax
cefoperazone Discontinued
cefotaxime Claforan
cefpodoxime Generic
ceftazidime Fortaz, Tazicef
ceftibuten Cedax
ceftriaxone Generic
Fourth generation cephalosporins
Fourth generation cephalosporins are structurally related to third-generation

cephalosporins but possess an extra ammonium group, which allows them to
rapidly penetrate through the outer membrane of gram-negative bacteria,
enhancing their activity. They are also active against β-lactamase
producing Enterobacteriaceae which may inactivate third-generation
cephalosporins.
Some fourth-generation cephalosporins have excellent activity against gram-

positive bacteria such as methicillin-susceptible staphylococci, penicillin-
resistant pneumococci, and viridans group streptococci.
Cefepime is the only fourth generation cephalosporin available in the United

States. Cefpirome is available overseas.
cefepime Maxipime
Next (fifth) generation cephalosporins
Ceftaroline is currently the only next-generation cephalosporin available in the

United States. It is active against methicillin-resistant Staphylococcus
aureus (MRSA) and gram-positive bacteria. It also retains the activity of the later-
generation cephalosporins and is effective against susceptible gram-negative
bacteria.
ceftaroline Teflaro
Are cephalosporins safe?
Cephalosporins are generally safe, with low toxicity and good efficacy against
susceptible bacteria.
Allergic reactions have been reported with cephalosporins and symptoms may
include a rash, hives (urticaria), swelling, or rarely, anaphylaxis. Up to 10% of
people with a history of penicillin allergy will also be allergic to cephalosporins.
Rarely, seizures have been reported with some cephalosporins; the risk is
greatest in those with kidney disease.
Cephalosporins have also been associated with a reduced ability of the blood to
clot leading to prolonged bleeding times. People with kidney or liver disease,
nutritionally deprived, taking cephalosporins long-term, or concurrently receiving
anticoagulant therapy are more at risk.
For a complete list of severe side effects, please refer to the individual drug
monographs.
What are the side effects of cephalosporins?

Cephalosporins generally cause few side effects. The most common side effects
reported include abdominal pain, diarrhea, dyspepsia, headache, gastritis,
and nausea and vomiting. Transient liver problems have also been reported.
Rarely, some people may develop a super-infection due to overgrowth of a

naturally occurring bacterium called Clostridium difficile, following use of any
antibiotic, including cephalosporins. Symptoms may include severe diarrhea.
Uncommonly, an overgrowth of the yeast, Candida albicans, may occur following

cephalosporin use, resulting in the symptoms of thrush.
What are Cephalosporins/beta-lactamase
inhibitors?
Cephalosporins are a group of broad spectrum, semi-synthetic beta-lactam
antibiotics derived from the mould Cephalosporium. The mechanism of action of
cephalosporins is the same as penicillins in that they interfere with bacterial cell
wall synthesis. They are classified according to the chronological order in which
they were produce. Beta-lactamase inhibitors block the activity of beta-lactamase
enzymes. Some species of bacteria produce beta-lactamase enzymes, which
cleave the beta-lactam group in antibiotics, such as cephalosporins, that have a
beta-lactam ring in their structure. In doing so the beta-lactamase enzyme
inactivates the antibiotic and becomes resistant to that antibiotic. To avoid
development of resistance, beta-lactamase inhibitors are administered with the
beta-lactam antibiotics so the action of beta-lactamase is inhibited. This tends to
widen the spectrum of antibacterial activity.
List of Cephalosporins/beta-lactamase
inhibitors:
Filter by:
View by: Brand | Generic
Drug Name Reviews Avg. Ratings
Avycaz (Pro) 0 reviews Add rating

Generic name: avibactam / ceftazidime
Zerbaxa (Pro)
Generic name: ceftolozane / tazobactam
1. Drug Classes
2. Anti-infectives
3. Cephalosporins
4. First Generation Cephalosporins
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First generation cephalosporins

Written by C. Fookes, BPharm on Jun 29, 2018
What are First generation cephalosporins?

Cephalosporins are a large group of antibiotics derived from the mold
Acremonium (previously called Cephalosporium). Cephalosporins are bactericidal
(kill bacteria) and work in a similar way to penicillins. They bind to and block the
activity of enzymes responsible for making peptidoglycan, an important
component of the bacterial cell wall. They are called broad-spectrum antibiotics
because they are effective against a wide range of bacteria.
First generation cephalosporins refer to the first group of cephalosporins

discovered. Their optimum activity is against gram-positive bacteria such
as staphylococci and streptococci. They have little activity against gram-negative
bacteria.
What are first generation cephalosporins

used for?
First generation cephalosporins may be used to treat infections caused by
susceptible bacteria such as:
 Bone infections
 Skin infections
 Upper respiratory tract infections
What are the differences between first

generation cephalosporins?
Cephalexin and cefadroxil can be given by mouth, whereas cefazolin can only
be given by injection (IV/IM). There are also differences with regards to how
frequently the different first-generation cephalosporins need to be dosed.
cefadroxil Duricef
cefazolin Ancef, Kefzol
cephadrine Discontinued
cephalexin Daxbia, Keflex
Are first generation cephalosporins safe?

First generation cephalosporins are generally safe, with low toxicity and good
efficacy against susceptible bacteria.
Allergic reactions have been reported with cephalosporins (including first

generation cephalosporins) and symptoms may include a rash, hives (urticaria),
swelling, or rarely, anaphylaxis. Up to 10% of people with a history of penicillin
allergy will also be allergic to cephalosporins.
Rarely, seizures have been reported with some cephalosporins; the risk is
Cephalosporins have also been associated with a reduced ability of the blood to
clot leading to prolonged bleeding times. People with kidney or liver disease,
nutritionally deprived, taking cephalosporins long-term, or concurrently receiving
anticoagulant therapy are more at risk.
monographs.
What are the side effects of first generation

cephalosporins?
First generation cephalosporins generally cause few side effects. The most
common side effects reported
include diarrhea, nausea and vomiting, dyspepsia, gastritis and abdominal
pain. Transient liver problems have also been reported.


cephalosporin use, resulting in the symptoms of thrush.
For a complete list of side effects, please refer to the individual drug
monographs.
Read more
List of First generation cephalosporins:

Filter by:

Duricef (Pro) 0 reviews 10

Generic name: cefadroxil
Velosef 0 reviews 10
Generic name: cephradine
Kefzol 0 reviews 9.0

Generic name: cefazolin
Keflex (Pro) 69 reviews 7.9

Generic name: cephalexin
Ancef (Pro) 0 reviews 6.5

Generic name: cefazolin
Biocef 0 reviews Add rating

Panixine
What are Fourth generation

cephalosporins?
mold Acremonium (previously called Cephalosporium). This mold yielded three
main compounds, historically called Cephalosporin N and C, and P, from which
the first cephalosporins were derived.
Cephalosporins are bactericidal (kill bacteria) and work in a similar way to

penicillins. They bind to and block the activity of enzymes responsible for making
peptidoglycan, an important component of the bacterial cell wall. They are called
broad-spectrum antibiotics because they are effective against a wide range of
bacteria.
Fourth generation cephalosporins refer to the fourth group of cephalosporins

discovered. They are structurally related to third-generation cephalosporins but
possess an extra ammonium group, which allows them to rapidly penetrate
through the outer membrane of Gram-negative bacteria, enhancing their activity.
They are also active against β-lactamase producing Enterobacteriaceae which may
inactivate third-generation cephalosporins.
Some fourth-generation cephalosporins have excellent activity against gram-

positive bacteria such as methicillin-susceptible staphylococci, penicillin-
resistant pneumococci and viridans group streptococci.
Cefepime is the only fourth generation cephalosporin available in the United

States. Cefpirome is available overseas.
List of Fourth generation cephalosporins:

Filter by:
Maxipime (Pro)
Generic name: cefepime
1. Drug Classes
2. Anti-infectives
3. Cephalosporins
4. Next Generation Cephalosporins

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Next generation cephalosporins

Other names: fifth generation cephalosporins, next-generation cephalosporins
What are Next generation cephalosporins?

mold Acremonium (previously called Cephalosporium). Cephalosporins are
bactericidal (kill bacteria) and work in a similar way to penicillins. They bind to
and block the activity of enzymes responsible for making peptidoglycan, an
important component of the bacterial cell wall. They are called broad-spectrum
antibiotics because they are effective against a wide range of bacteria.
cephalosporins are made. So far there are five generations of cephalosporins.
Next generation cephalosporins were the fifth generation of cephalosporins to be
developed.
What are next generation cephalosporins

used for?
Next generation cephalosporins have activity against multi-resistant
Staphylococcus aureus (MRSA), gram-positive bacteria and some gram-negative
bacteria. Ceftaroline is currently the only next-generation cephalosporin
available in the United States. In adults and children aged two years and older it
is approved to treat:
 Pneumonia that is acquired in the community (not in hospital)

 Skin and skin structure infections.
What are the differences between next

Ceftaroline is currently the only next-generation cephalosporin available in the
United States. It is active against methicillin-resistant Staphylococcus
aureus (MRSA) and gram-positive bacteria. It also retains the activity of the later-
generation cephalosporins and is effective against susceptible gram-negative
bacteria.
ceftaroline Teflaro
Are next generation cephalosporins safe?

Next generation cephalosporins are generally safe, with low toxicity and good
Allergic reactions have been reported with all cephalosporins including

ceftaroline and symptoms may include a rash, hives (urticaria), swelling, or
rarely, anaphylaxis. Up to 10% of people with a history of penicillin allergy will
also be allergic to cephalosporins.
A positive Coombs test (a test that checks your blood for antibodies that attack
red blood cells) has been reported in up to 18% of children and 11% of adults
taking ceftaroline. This may be associated with red blood cell hemolysis and
drug-induced hemolytic anemia should be suspected if anemia develops during
or after treatment.
Rarely, seizures have been reported with ceftaroline; the risk may be greatest in
those with kidney disease.
For a complete list of severe side effects, please refer to the ceftaroline drug
monograph.
What are the side effects of next generation

cephalosporins?
Ceftaroline generally causes few side effects. The most common side effects
reported include:
 Abdominal pain
 Constipation
 Diarrhea
 Dyspepsia
 A headache
 Insomnia
 Itchy skin
 Gastritis
 Nausea
 Rash
 Vomiting.
Transient increases in liver enzymes have also been reported
For a complete list of side effects, please refer to the ceftaroline drug
monograph.
List of Next generation cephalosporins:

Filter by:
Teflaro (Pro)
Generic name: ceftaroline
What are second generation cephalosporins

used for?
Second generation cephalosporins may be used to treat the following types of
infections when caused by susceptible strains of bacteria:
 Bone and joint infections

 Gynecological infections
 Intra-abdominal infections
 Lower respiratory tract infections
 Skin and skin structure infections
 Urinary tract infections

What are the differences between second

Second generation cephalosporins have activity against gram-negative aerobes
such as Morganella morganii, Neisseria gonorrhoeae (non-penicillinase producing
strains), Haemophilus influenzae, Klebsiella species, and Escherichia coli; gram-
positive aerobes such as Streptococcus pneumoniae, Staphylococcus
aureus, S. epidermidis and S. pyrogenes; and several types of anaerobes.
Some bacteria, such as most strains
of Pseudomonas aeruginosa and Acinetobacter species, are resistant to second
generation cephalosporins.
Second-generation cephalosporins are more active against gram-negative

bacteria than first generation cephalosporins
cefotetan Cefotan
cefoxitin Mefoxin
cefprozil Cefzil
cefuroxime Ceftin, Zinacef
loracarbef Discontinued
Are second generation cephalosporins safe?

Second generation cephalosporins are generally safe, with low toxicity and good
Allergic reactions have been reported with all cephalosporins including second
generation cephalosporins and symptoms may include a rash, hives (urticaria),
Drug-induced hemolytic anemia has been associated with the use of some
cephalosporins, including second generation cephalosporins; suspect and
investigate further if anemia develops during or after treatment.
Rarely, seizures have been reported with cephalosporins; the risk may be
monographs.
What are the side effects of second

Second generation cephalosporins generally cause few side effects. The most
common side effects reported include:
 Abdominal pain
 Diarrhea
 Nausea
 Rash
 Vomiting.
Transient increases in liver enzymes have also been reported
monographs.
List of Second generation cephalosporins:

Filter by:

Lorabid (Pro) 1 review 9.0

Generic name: loracarbef
Cefotan (Pro) 0 reviews 8.0

Generic name: cefotetan
Zinacef (Pro) 0 reviews 8.0

Generic name: cefuroxime
Ceftin (Pro) 43 reviews 7.4

Generic name: cefuroxime
Cefzil (Pro) 11 reviews 6.3

Generic name: cefprozil
Lorabid Pulvules 0 reviews Add rating

Generic name: loracarbef
Mefoxin (Pro)
Generic name: cefoxitin
What are third-generation cephalosporins

used for?
Third generation cephalosporins may be used to treat the following types of
infections when caused by susceptible strains of bacteria:
 Bacteremia/septicemia
 Bone and joint infections
 Central nervous system infections
 Gynecological infections
 Intra-abdominal infections
 Lower respiratory tract infections
 Skin and skin structure infections

What are the differences between third-

There are differences between third-generation cephalosporins with regards to
the bacteria they are effective against. No one third-generation cephalosporin
treats all infectious disease scenarios.
Cefotaxime and ceftizoxime (discontinued) offer the best gram-positive

coverage out of all the third-generation agents; ceftazidime and cefoperazone
(discontinued) are unique in that they provide antipseudomonal coverage.
Ceftriaxone has a long half-life which allows for once daily dosing and may be
used for the treatment of gonorrhea, pelvic inflammatory disease, and
epididymo-orchitis. It is also an alternative to penicillins for
suspected meningitis.
All the third-generation cephalosporins except for cefoperazone (discontinued)

penetrate cerebrospinal fluid.
cefdinir Omnicef
cefditoren Spectracef
cefixime Suprax
cefoperazone Discontinued
cefotaxime Claforan
cefpodoxime Generic
ceftazidime Fortaz, Tazicef
ceftibuten Cedax
ceftriaxone Generic
Are third generation cephalosporins safe?

Third generation cephalosporins are generally safe, with low toxicity and good
Allergic reactions have been reported with all cephalosporins including third
generation cephalosporins and symptoms may include a rash, hives (urticaria),
Drug-induced hemolytic anemia has been associated with use of some

cephalosporins, including third generation cephalosporins; suspect and
investigate further if anemia develops during or after treatment.

Rarely, seizures have been reported with cephalosporins; the risk may be
Cephalosporin should be given exactly as directed. Potentially life-threatening
arrhythmias have been reported following rapid bolus administration of
cefotaxime, a third generation cephalosporin.
monographs.
What are the side effects of third

Third generation cephalosporins generally cause few side effects. The most
common side effects reported include:
 Abdominal pain
 Diarrhea
 Injection site inflammation
 Itchy skin
 Nausea
 Rash
 Vomiting.
Transient increases in liver enzymes have also been reported.
monographs.
List of Third generation cephalosporins:

Filter by:
Cedax (Pro) 3 reviews 9.2

Generic name: ceftibuten
Rocephin (Pro) 91 reviews 8.6

Generic name: ceftriaxone
Claforan (Pro) 0 reviews 8.0

Generic name: cefotaxime
Vantin (Pro) 6 reviews 7.8

Generic name: cefpodoxime
Omnicef (Pro) 47 reviews 6.5

Generic name: cefdinir
Suprax (Pro) 8 reviews 6.3

Generic name: cefixime
Omnicef Omni-Pac 2 reviews 4.0

Generic name: cefdinir
Spectracef (Pro) 3 reviews 3.7

Generic name: cefditoren
Cefizox 0 reviews Add rating

Generic name: ceftizoxime
Cefobid 0 reviews Add rating

Generic name: cefoperazone
Ceptaz 0 reviews Add rating

Generic name: ceftazidime
Fortaz (Pro) 0 reviews Add rating

Tazicef (Pro)
1. Reference
2. Antibiotics
Print Share
Antibiotics Guide
Medically reviewed by L. Anderson, PharmD Last updated on Jun 11, 2019.
 Care Notes
 Medication List
 Q&A
When To Use|When NOT To Use|Top 10 Infections Treated|Top 10 Generic

Drugs|Top 10 Brand Drugs|Antibiotic Class Types|OTC Options |More
Resources
Taking Antibiotics
You’ve most likely taken an antibiotic or anti-infective at least once in your
lifetime. From treatments for painful strep throat or ear infections as a child, to
burning urinary tract infections or itchy skin infections as an adult, antibiotics are
one of the most highly utilized and important medication classes we have in
medicine.
Understanding the vast world of antibiotics and anti-infectives is no easy

task. Anti-infectives are a large class of drugs that cover a broad range of
infections, including fungal, viral, bacterial, and even protozoal infections.
 Athletes foot? That’s a common fungal infection.
 HIV? Antiviral medications are always needed.
 Bladder infection? Yes, that may need a common oral antibiotic.
 Head lice? A topical anti-parasitic can alleviate the itching.
There is no one type of antibiotic that cures every

infection. Antibiotics specifically treat infections caused by bacteria, such as
Staph., Strep., or E. coli., and either kill the bacteria (bactericidal) or keep it from
reproducing and growing (bacteriostatic). Antibiotics do not work against
any viral infection.
When To Use Antibiotics

Antibiotics are specific for the type of bacteria being treated and, in general,
cannot be interchanged from one infection to another. When antibiotics are used
correctly, they are usually safe with few side effects.
However, as with most drugs, antibiotics can lead to side effects that may range
from being a nuisance to serious or life-threatening. In infants and the elderly, in
patients with kidney or liver disease, in pregnant or breastfeeding women, and in
many other patient groups antibiotic doses may need to be adjusted based upon
the specific characteristics of the patient, like kidney or liver function, weight, or
age. Drug interactions can also be common with antibiotics. Health care
providers are able to assess each patient individually to determine the correct
antibiotic and dose.
When NOT To Use Antibiotics

Antibiotics are not the correct choice for all infections. For example, most sore
throats, cough and colds, flu or acute sinusitis are viral in origin (not bacterial)
and do not need an antibiotic. These viral infections are “self-limiting”, meaning
that your own immune system will usually kick in and fight the virus off. In fact,
using antibiotics for viral infections can increase the risk for antibiotic resistance,
lower the options for future treatments if an antibiotic is needed, and put a
patient at risk for side effects and extra cost due to unnecessary drug treatment.
Antibiotic resistant bacteria cannot be fully inhibited or killed by an antibiotic,
even though the antibiotic may have worked effectively before the resistance
occurred. Don't share your antibiotic or take medicine that was prescribed for
someone else, and don't save an antibiotic to use the next time you get sick.
To better understand antibiotics, it’s best to break them down into common
infections, common antibiotics, and the top antibiotic classes as listed in
Drugs.com.
Top 10 List of Common Infections Treated

with Antibiotics
1. Acne
2. Bronchitis
3. Conjunctivitis (Pink Eye)
4. Otitis Media (Ear Infection)
5. Sexually Transmitted Diseases (STD’s)
6. Skin or Soft Tissue Infection
7. Streptococcal Pharyngitis (Strep Throat)
8. Traveler’s diarrhea
9. Upper Respiratory Tract Infection
10. Urinary Tract Infection (UTI)
Top 10 List of Generic Antibiotics

1. amoxicillin
2. doxycycline
3. cephalexin
4. ciprofloxacin
5. clindamycin
6. metronidazole
7. azithromycin
8. sulfamethoxazole and trimethoprim
9. amoxicillin and clavulanate
10. levofloxacin
Top 10 List of Brand Name Antibiotics
1. Augmentin
2. Flagyl, Flagyl ER
3. Amoxil
4. Cipro
5. Keflex
6. Bactrim, Bactrim DS
7. Levaquin
8. Zithromax
9. Avelox
10. Cleocin
Top 10 List of Antibiotic Classes (Types of

Antibiotics)
1. Penicillins
2. Tetracyclines
3. Cephalosporins
4. Quinolones
5. Lincomycins
6. Macrolides
7. Sulfonamides
8. Glycopeptides
9. Aminoglycosides
10. Carbapenems
Most antibiotics fall into their individual antibiotic classes. An antibiotic class is a
grouping of different drugs that have similar chemical and pharmacologic
properties. Their chemical structures may look comparable, and drugs within the
same class may kill the same or related bacteria.
However, it is important not to use an antibiotic for an infection unless your

doctor specifically prescribes it, even if it's in the same class as another drug you
were previously prescribed. Antibiotics are specific for the kind of bacteria they
kill. Plus, you would need a full treatment regimen to effectively cure your
infection, so don't use or give away leftover antibiotics.
1. Penicillins
Another name for this class is the beta-lactam antibiotics, referring to their
structural formula. The penicillin class contains five groups of
antibiotics: aminopenicillins, antipseudomonal penicillins, beta-lactamase
inhibitors, natural penicillins, and the penicillinase resistant penicillins.
Common antibiotics in the penicillin class include:
Generic Brand Name Examples
amoxicillin Amoxil
amoxicillin and clavulanate Augmentin, Augmentin ES-600, Augmentin XR
ampicillin Unasyn
dicloxacillin Dynapen (discontinued)
oxacillin Bactocill (discontinued)
penicillin V potassium PC Pen VK (discontinued)
Certain penicillinase-resistant penicillins (such as oxacillin or dicloxacillin) are

inherently resistant to certain beta-lactamase enzymes by themselves. Others, for
example, amoxicillin or ampicillin have greater antibacterial activity when they
are combined with a beta-lactamase inhibitor like clavulanate, sulbactam, or
tazobactam.
View all penicillin drugs

2. Tetracyclines
Tetracyclines are broad-spectrum against many bacteria and treat conditions
such as acne, urinary tract infections (UTIs), intestinal tract infections, eye
infections, sexually transmitted diseases, periodontitis (gum disease), and other
bacterial infections. The tetracycline class contains drugs such as:
demeclocycline Declomycin
doxycycline Adoxa, Doryx, Doxy 100, Oracea, Vibramycin
eravacycline Xerava
minocycline Dynacin, Minocin, Solodyn
omadacycline Nuzyra
tetracycline Panmycin, Sumycin
View all tetracycline drugs
3. Cephalosporins
There are five generations of cephalosporins, with increasing expanded
coverage across the class to include gram-negative infections. Newer generations
with updated structures are developed to allow wider coverage of certain
bacteria. Cephalosporins are bactericidal (kill bacteria) and work in a similar way
as the penicillins. Cephalosporins treat many types of infections, including strep
throat, ear infections, urinary tract infections, skin infections, lung infections, and
meningitis. Common medications in this class include:
cefaclor Ceclor (brand discontinued)
cefdinir Omnicef (discontinued)
cefotaxime Claforan
ceftazidime Avycaz, Fortaz, Tazicef
ceftriaxone Rocephin (discontinued)
cefuroxime Zinacef
The fifth generation (or next generation) cephalosporin known

as ceftaroline (Teflaro) is active against methicillin-resistant Staphylococcus
aureus (MRSA). Avycaz contains the the beta-lactamase inhibitor avibactam.
View all cephalosporin drugs
4. Quinolones
The quinolones, also known as the fluoroquinolones, are a synthetic, bactericidal
antibacterial class with a broad-spectrum of activity. The quinolones can be used
for difficult-to-treat urinary tract infections when other options are aren’t
effective, hospital-acquired pneumonia, bacterial prostatitis, and even anthrax or
plague.
The FDA has issued several strong warnings about this class due to potential
disabling side effects. Learn More: Fluoroquinolone Antibacterial Drugs for
Systemic Use: Drug Safety Communication - Warnings Updated Due to
Disabling Side Effects
Common drugs in the fluoroquinolone class include:

ciprofloxacin Cipro, Cipro XR
levofloxacin Levaquin
moxifloxacin Avelox
Several quinolones are also available in drop form to treat eye or ear infections.
View all quinolone drugs
5. Lincomycins
This class has activity against gram-positive aerobes and anaerobes (bacteria that
can live without oxygen), as well as some gram-negative anaerobes. The
lincomycin derivatives may be used to treat serious infections like pelvic
inflammatory disease, intra-abdominal infections, lower respiratory tract
infections, and bone and joint infections. Some forms are also used topically on
the skin to treat acne. These drugs include:
clindamycin Cleocin, Cleocin T, Evoclin
lincomycin Lincocin
View all lincomycin drugs
6. Macrolides
The macrolides can be use to treat community-acquired pneumonia, pertussis
(whooping cough), or for uncomplicated skin infections, among other susceptible
infections. Ketolides are a newer generation of antibiotic developed to overcome
macrolide bacterial resistance. Frequently prescribed macrolides are:
azithromycin Zithromax
clarithromycin Biaxin
erythromycin E.E.S., Ery-Tab, Eryc
View all macrolide drugs
7. Sulfonamides
Sulfonamides are effective against some gram-positive and many gram-negative
bacteria, but resistance is widespread. Uses for sulfonamides include urinary tract
infections (UTIs), treatment or prevention of pneumocystis pneumonia, or ear
infections (otitis media). Familiar names include:
sulfamethoxazole and trimethoprim Bactrim, Bactrim DS, Septra
sulfasalazine Azulfidine
sulfisoxazole (product discontinued) Eryzole (discontinued), Gantrisin (discontinued)
View all sulfonamides drugs
8. Glycopeptide Antibiotics
Members of this group may be used for treating methicillin-
resistant staphylococcus aureus (MRSA) infections, complicated skin infections, C.
difficile-associated diarrhea, and enterococcal infections such as endocarditis
which are resistant to beta-lactams and other antibiotics. Common drug names
include:
dalbavancin Dalvance
oritavancin Orbactiv
telavancin Vibativ
vancomycin Firvanq, Vancocin
View all glycopeptide drugs
9. Aminoglycosides
Aminoglycosides inhibit bacterial synthesis by binding to the 30S ribosome and
act rapidly as bactericidal antibiotics (killing the bacteria). These drugs are usually
given intravenously (in a vein through a needle). Common examples in this class
are:
gentamicin Garamycin (discontinued), Genoptic
tobramycin TOBI, Tobradex, Tobrex
amikacin Amikin
View all aminoglycoside drugs
10. Carbapenems
These injectable beta-lactam antibiotics have a wide spectrum of bacteria-killing
power and may be used for moderate to life-threatening bacterial infections like
stomach infections, pneumonias, kidney infections, multidrug-resistant hospital-
acquired infections and many other types of serious bacterial illnesses. They are
often saved for more serious infections or used as "last-line" agents to help
prevent resistance. Members of this class include:
imipenem and cilastatin Primaxin
meropenem Merrem
doripenem Doribax (discontinued)
ertapenem Invanz
View all carbapenems drugs
Are There Any Over-the-Counter

Antibiotics?
Over-the-counter (OTC) oral antibiotics are not approved in the U.S. A bacterial
infection is best treated with a prescription antibiotic that is specific for the type
of bacteria causing the infection. Using a specific antibiotic will increase the
chances that the infection is cured and help to prevent antibiotic resistance. In
addition, a lab culture may need to be performed to pinpoint the bacteria and to
help select the best antibiotic. Taking the wrong antibiotic -- or not enough --
may worsen the infection and prevent the antibiotic from working the next time.
There are a few over-the-counter topical antibiotics that can be used on the
skin. Some products treat or prevent minor cuts, scrapes or burns on the skin that
may get infected with bacteria. These are available in creams, ointments, and
even sprays.
Common OTC topical antibiotics:

 Neosporin (bacitracin, neomycin, polymyxin B)
 Polysporin (bacitracin, polymyxin B)
 Triple antibiotic, generic (bacitracin, neomycin, polymyxin B)
 Neosporin + Pain Relief Ointment (bacitracin, neomycin, polymyxin B,
pramoxine)
There are some OTC antibacterials for treating acne, too. They contain the
antibacterial benzoyl peroxide, which also has mild drying effect for acne. Many
products are found on the pharmacy shelves as gels, lotions, solutions, foams,
cleaning pads, and even facial scrubs.
Common OTC antibacterials for acne:
 Clearskin
 Oxy-10
 Proactiv
1. Drug Classes
2. Anti-infectives
3. Penicillins
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Penicillins
Medically reviewed by C. Fookes, BPharm Last updated on Apr 5, 2018.
What are Penicillins?

Penicillins are a type of antibiotic derived from Penicillium fungi. An antibiotic is a
type of medicine that inhibits the growth of, or kills, bacteria.
Penicillin G (also called benzylpenicillin) was discovered by accident in 1928.

Alexander Fleming, a Scottish physician-scientist was growing a type of bacteria
called Staphylococcus Aureus on an uncovered petri dish when it became
contaminated with mold spores. He observed that the areas of bacteria near the
mold were dying. He isolated the substance from the mold that was killing the
bacteria and called it penicillin.
Another naturally occurring penicillin, penicillin V was later isolated from the
same mold. All other penicillins are semi-synthetic (made by modifying the
structure of the original naturally occurring penicillins). Modification extends their
spectrum of activity, allows them to be taken orally, and increases their resistance
against penicillinase, an enzyme produced by some bacteria that inactivates
penicillin.
Penicillins work by preventing the cross linking of amino acid chains in the
bacterial cell wall. This does not affect pre-existing bacteria, but newly produced
bacterial cells have weak cell walls that easily rupture.
What are penicillins used for?

Penicillins may be used to treat a wide range of infections caused by susceptible
bacteria, such as:
 Dental abscess
 Gonorrhea
 Pneumonia
 Respiratory tract infections
 Rheumatic fever
 Scarlet fever
 Skin infections
penicillins?
The natural penicillins (penicillin G and penicillin V) are only active against
gram-positive bacteria (see below for an explanation). Penicillin V is more acid-
resistant than penicillin G, which means it can be taken orally.
Modern semi-synthetic penicillins include ampicillin, carbenicillin (discontinued),

and oxacillin. These can be taken orally, have some degree of resistance to beta
lactamase, and are effective against some gram-negative bacteria. Most bacteria
can be classified as gram-positive or gram-negative based on differences in their
cell wall structure, which can be distinguished under a microscope using a type of
dye. One of the most important differences between these two types of bacteria
is that gram-positive bacteria are more susceptible to antibiotics while gram-
negative bacteria are more resistant to antibiotics.
Antipseudomonal penicillins, such as piperacillin and ticarcillin (discontinued) are

penicillins that have additional activity against some hard-to-kill types of gram-
negative bacteria such as Pseudomonas, Enterococcus and Klebsiella. They are
useful for urinary tract infections caused by susceptible bacteria because they
concentrate in the urine.
Some penicillins are combined with a beta-lactamase inhibitor. A beta-lactamase

inhibitor blocks the activity of beta-lactamase enzymes but tends to have little
antibiotic activity on its own. Some penicillins (such as oxacillin, dicloxacillin,
and nafcillin) are naturally resistant to certain beta-lactamases and are called
penicillinase-resistant penicillins. Others, such as amoxicillin, ampicillin,
and piperacillin can have their activity extended by combining them with a beta-
lactamase inhibitor. Clavulanate, sulbactam, and tazobactam are all beta-
lactamase inhibitors.
Common penicillins available in the U.S.

Aminopenicillins
Spectrum of activity:
 Most gram-positive bacteria, some gram-negative bacteria (such as E.
coli and H. influenzae).
amoxicillin Amoxil, Moxatag
ampicillin Principen
Antipseudomonal penicillins
 Most gram-positive and gram-negative bacteria

 Antipseudomonal and antiprotozoal activity
 Usually given with a beta lactamase.
piperacillin Pipracil
Beta-lactamase inhibitors
 Effective against most gram-positive and gram-negative bacteria including

those that produce beta-lactamases
(eg, bacteroides sp., enterococcus sp., staphylococcus sp.)
amoxicillin/clavulanate Augmentin, Amoclan

ampicillin/sulbactam Unasyn
piperacillin/tazobactam Zosyn
Natural penicillins
 Effective against most gram-positive bacteria and a limited number of

gram-negative bacteria.
penicillin g benzathine Bicillin L-A
penicillin v Penicillin VK
Penicillinase-resistant penicillins
 Effective against most gram-positive and gram-negative bacteria

 Naturally resistant to beta-lactamase.
dicloxacillin Dycill
nafcillin Unipen
oxacillin Bactocill
Are penicillins safe?
Penicillins are generally safe, with low toxicity and good efficacy against
susceptible bacteria.
Many people believe that they are allergic to penicillin. However, true penicillin
allergy is rare, and only occurs in 0.01-0.05% of people who take penicillin.
Symptoms may include nausea, vomiting, itchy skin, rash, wheezing, swelling
around the throat, and respiratory collapse.
What are the side effects of penicillins?

Penicillins generally cause few side effects. The most common side effects
reported include abdominal pain, headache, rash, diarrhea, and taste perversion.
Penicillins may cause anaphylaxis in those allergic to penicillin, but the overall
incidence of anaphylaxis is rare (0.01-0.05%).

antibiotic, including penicillins. Symptoms may include severe diarrhea.

penicillin use, resulting in the symptoms of thrush.
1. Drug Classes
2. Anti-infectives
3. Tetracyclines
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Tetracyclines
What are Tetracyclines?
Tetracyclines are a class of antibiotics that may be used to treat infections caused
by susceptible microorganisms such as gram positive and gram negative bacteria,
chlamydiae, mycoplasmata, protozoans, or rickettsiae.
They were discovered in the 1940s and the first tetracyclines were obtained or
derived from Streptomyces bacteria.
Tetracyclines inhibit protein synthesis in the microbial RNA (an important

molecule that acts as a messenger for DNA). They are primarily bacteriostatic
which means that they prevent bacteria from multiplying but don't necessarily kill
them.
Although tetracyclines are still widely used in human and veterinary medicine, the
emergence of bacterial resistance has limited their effectiveness and is of major
concern.
What are tetracyclines used for?

Tetracyclines are used widely in both human and veterinary medicine; for
example, tetracyclines have been used:
 For the prevention of malaria

 For the treatment of moderate-to-severe acne or rosacea
 To treat anthrax
 To treat infections of the eye, gastrointestinal tract, genitourinary tract,
gums, respiratory tract, and skin
 To treat infections caused by lice, mites, or ticks (such as Rocky Mountain
spotted fever, typhus fever)
 To treat infections caused by Campylobacter, Chlamydiae, Yersinia
pestis (plague), Vibrio cholerae (cholera) and other atypical organisms
 To treat respiratory tract infections caused by Mycoplasma pneumoniae
 As a growth promoter in animals.
Because many strains of microorganisms are now resistant to some tetracyclines,

culture and susceptibility testing is recommended before beginning treatment.
Doxycycline is a tetracycline that may be considered when penicillin is
contraindicated.

tetracyclines?
Although tetracyclines all work in the same way, there are differences between
the four tetracyclines (demeclocycline, doxycycline, minocycline,
and tetracycline) that are available in the U.S.
Doxycycline is the most widely prescribed tetracycline because it has the

advantage of once or twice daily dosing, availability as both an oral and an IV
preparation, and it may be taken with food without significant disruption to its
absorption. It is also less likely than other tetracyclines to cause photosensitivity
or to bind to calcium and cause tooth discoloration or bony growth
retardation. Conversely, there has been a resurgence in use of IV minocycline
because resistance appears lower with minocycline compared with other
tetracyclines.
demeclocycline Declomycin
doxycycline Adoxa, Doryx, Vibramycin
minocycline Dynacin, Minocin, Solodyn
tetracycline Ala-tet, Tetracap
Are tetracyclines safe?

Tetracyclines are considered safe when used at the recommended dosages for
the recommended duration of time. However, tetracyclines have been associated
with serious side effects, such as:
 Tooth discoloration (yellow-gray-brown) and bony growth retardation
when given during tooth or bone development (last half of pregnancy,
infancy, and during childhood up until the age of 8 years)
 Clostridium difficile associated diarrhea (CDAD). CDAD ranges in severity
from mild diarrhea to fatal colitis and has been associated with nearly all
antibacterial agents, not just tetracyclines
 Intracranial hypertension (increased pressure within the brain) has been
associated with tetracycline use. Symptoms include a headache; double,
blurred, or loss of vision. Women of childbearing age who
are overweight or who have a history of intracranial hypertension are most
at risk. Coadministration of isotretinoin increases the risk and is
contraindicated
 Toxicity to a developing fetus (tetracyclines can slow skeletal
development). Tetracyclines should only be used in pregnancy if the
benefits outweigh the risk
 Drug Rash with Eosinophilia and Systemic Symptoms (DRESS). Symptoms
include widespread rash, fever, and swollen lymph nodes, and is potentially
fatal. Discontinue the tetracycline immediately.
monographs.
What are the side effects of tetracyclines?

The following are some of the side effects that have been reported with
tetracyclines:
 Gastrointestinal effects such as acid reflux, diarrhea, nausea, vomiting,

stomach cramps, or loss of appetite
 A headache
 An increase in some laboratory values (such as blood urea nitrogen [BUN])
particularly in people with impaired renal function. This does not appear to
happen with doxycycline
 Photosensitivity reactions (such as an exaggerated sunburn reaction).
Rarely occurs with minocycline
 Pigmentation or discoloration of the skin and mucous membranes
(minocycline only)
 Skin rash or itching
 Sore mouth or tongue
 Vaginal itching or discharge.
Demeclocycline has also been associated with increased thirst, increased

frequency of urination and unusual tiredness. Minocycline has been associated
with dizziness, light-headedness, and unsteadiness. Tetracyclines may also cause
darkening or discoloration of the tongue but this is usually temporary.
monographs.
Read more
List of Tetracyclines:
Filter by:
Drug Name Reviews Avg. Ra
Adoxa TT 0 reviews 1
Generic name: doxycycline
Oraxyl 0 reviews 1
Adoxa (Pro) 4 reviews 9

Declomycin (Pro) 2 reviews 9

Generic name: demeclocycline
Dynacin (Pro) 2 reviews 9

Generic name: minocycline
Oracea (Pro) 43 reviews 8

Monodox (Pro) 33 reviews 7

Minocin (Pro) 18 reviews 7

Doxy 100 (Pro) 18 reviews 7

Vibramycin (Pro) 8 reviews 7

Doryx (Pro) 65 reviews 7

Solodyn (Pro) 100 reviews 7

Acticlate (Pro) 7 reviews 6

Terramycin 0 reviews 5
Generic name: oxytetracycline
Achromycin V 0 reviews Add ra

Generic name: tetracycline
Actisite 0 reviews Add ra

Adoxa CK 0 reviews Add ra

Ala-Tet 0 reviews Add ra

Alodox 0 reviews Add ra

Avidoxy 0 reviews Add ra

Avidoxy DK 0 reviews Add ra

Generic name: doxycycline / salicylic acid
Brodspec 0 reviews Add ra

Cleeravue-M 0 reviews Add ra

Minocin for Injection 0 reviews Add ra

Minolira (Pro) 0 reviews Add ra

Morgidox 0 reviews Add ra

Myrac 0 reviews Add ra

NutriDox Convenience Kit 0 reviews Add ra

Generic name: doxycycline / omega-3 polyunsaturated fatty acids
Nuzyra (Pro) 0 reviews Add ra

Generic name: omadacycline
Ocudox 0 reviews Add ra

Panmycin 0 reviews Add ra

Periostat (Pro) 0 reviews Add ra

Seysara (Pro) 0 reviews Add ra

Generic name: sarecycline
Sumycin (Pro) 0 reviews Add ra

Tetracap 0 reviews Add ra

Tetracon 0 reviews Add ra

Vibra-Tabs 1 review Add ra

Xerava (Pro) 0 reviews Add ra

Generic name: eravacycline
Ximino (Pro)
1. Drug Classes
2. Anti-infectives
3. Quinolones
Print Share
Quinolones
Written by C. Fookes, BPharm on Apr 12, 2018
Other names: fluoroquinolones
What are Quinolones?

Quinolones are a type of antibiotic. Antibiotics kill or inhibit the growth of
bacteria.
There are five different quinolone classes. In addition, another class of antibiotic,
called fluoroquinolones, were derived from quinolones by modifying their
structure with fluorine. Quinolones and fluoroquinolones have many things in
common, but also a few differences such as what organisms they are effective
against. Some people use the words quinolones and fluoroquinolones
interchangeably.
Quinolones and fluoroquinolones detrimentally affect the function of two

enzymes produced by bacteria, topoisomerase IV and DNA gyrase, so that they
can no longer repair DNA or help in its manufacture.
What are quinolones and fluoroquinolones
used for?
Quinolones and fluoroquinolones are considered broad-spectrum antibiotics.
This means that they are effective against a wide range of bacteria.
However, because of their risk of serious side effects, the FDA has advised that
they are not suitable for common conditions such as sinusitis, bronchitis, and
uncomplicated urinary tract infections, and should only be considered when
treatment with other, less toxic antibiotics, has failed.
Quinolones and fluoroquinolones may also be used to treat unusual infections

such as anthrax or plague. Doctors may also decide to use them for other types
of infection when other alternative treatment options have failed or cannot be
used.

quinolones and fluoroquinolones?
Quinolones and fluoroquinolones differ in their activity against the two enzymes
produced by bacteria, topoisomerase IV and DNA gyrase. Those that are more
active against topoisomerase IV have more of an effect against gram-positive
bacteria, those that are active against DNA gyrase, are more active against gram-
negative bacteria. Newer fluoroquinolones tend to target these enzymes equally.
Quinolones and fluoroquinolones also differ in the way they are absorbed,
metabolized and excreted in the body.
Table: List of common quinolones and fluoroquinolones
cinoxacin Discontinued in the U.S.

ciprofloxacin Cipro, Proquin XR
delafloxacin Baxdela
gemifloxacin Factive
levofloxacin Levaquin
moxifloxacin Avelox
nalidixic acid Discontinued in the U.S.
norfloxacin Discontinued in the U.S.
ofloxacin Floxin
sparfloxacin Discontinued in the U.S.
Are quinolones and fluoroquinolones safe?

Quinolones and fluoroquinolones should be avoided in children under the age of
18 years unless they have a serious infection that cannot be treated with any
other antibiotic. This is because they can damage the weight-bearing joints in
children, and children are also more susceptible to other adverse effects of
quinolones and fluoroquinolones, including tendinitis and tendon rupture.
The FDA has some concerns about quinolones and fluoroquinolones and
considers them unsuitable for most common infections because they have been
associated with some serious effects, including tendinitis (inflammation of a
tendon) and tendon rupture. In addition, some people have reported peripheral
neuropathy (nerve pain in the fingers and toes) and central nervous system
effects such as agitation, attention problems, disorientation, memory
impairment, nervousness, and delirium while taking quinolones or
fluoroquinolones. They have also been associated with low blood sugar levels
(hypoglycemia). All quinolones and fluoroquinolones are required by the FDA to
carry safety warnings about these potentially serious side effects.
The risk of tendinitis and tendon rupture is increased in people over the age of
60, in those taking corticosteroids, or with a history of organ transplant. Previous
tendon disorders or strenuous activity may also increase risk.
Occasionally, liver damage and allergic reactions have occurred in people taking
quinolones or fluoroquinolones.
If any of these very severe side effects happen, the quinolone or fluoroquinolone
should be discontinued immediately, and all other quinolones and
fluoroquinolones avoided in the future.
What are the side effects of quinolones and

fluoroquinolones?
The most commonly reported side effects include diarrhea, nausea, abnormal
liver function tests, vomiting, and rash.
Quinolones and fluoroquinolones may also cause anxiety, insomnia, psychotic

reactions, nerve pain or a loss of feeling in the extremities, electrocardiogram
(ECG) abnormalities, increased sensitivity to light and other effects.
In people with myasthenia gravis, they may exacerbate muscle weakness and
may trigger seizures or increase the risk of having a seizure.
In people with diabetes, quinolones and fluoroquinolones may affect blood

glucose levels requiring extra monitoring.
Quinolones and fluoroquinolones increase the sensitivity of the skin to the sun
and may cause photo-sensitivity reactions and severe sunburn on exposed areas
of skin.
Quinolones and fluoroquinolones are not suitable for people with myasthenia
gravis, certain heart rhythm disturbances, or children and adolescents under the
age of 18 (unless the infection cannot be treated by another antibiotic).
Read more
List of Quinolones:
Filter by:
Avelox I.V. (Pro) 1 review 10

Generic name: moxifloxacin
Maxaquin 0 reviews 10
Generic name: lomefloxacin
Tequin 0 reviews 8.7

Generic name: gatifloxacin
Noroxin (Pro) 2 reviews 8.5

Generic name: norfloxacin
Floxin (Pro) 2 reviews 7.8

Generic name: ofloxacin
Avelox (Pro) 155 reviews 6.8

Generic name: moxifloxacin
NegGram 1 review 6.0

Generic name: nalidixic acid
Cipro (Pro) 283 reviews 5.7

Generic name: ciprofloxacin
Baxdela (Pro) 1 review 5.5

Generic name: delafloxacin
Levaquin (Pro) 376 reviews 5.4

Generic name: levofloxacin
Proquin XR (Pro) 1 review 5.0

Cipro I.V. 3 reviews 4.3

Factive (Pro) 9 reviews 3.8

Generic name: gemifloxacin
Cipro XR (Pro) 2 reviews 2.0

Cinobac 0 reviews Add rating

Generic name: cinoxacin
Trovan 0 reviews Add rating

Generic name: trovafloxacin
Zagam
Generic name: sparfloxacin
What are Lincomycin derivatives?

Lincomycin derivatives are a small group of antibiotics that inhibit synthesis of
bacterial proteins, essential for bacteria to survive. Lincomycin derivatives are
reserved for treatment of infections due to susceptible strains of pneumococci,
staphylococci and streptococci. One derivative is also indicated for treatment of
Plasmodium falciparum (malaria).
List of Lincomycin derivatives:

Filter by:
Lincocin (Pro) 1 review 10

Generic name: lincomycin
Cleocin HCl 3 reviews 8.5

Generic name: clindamycin
Cleocin (Pro) 16 reviews 6.1

Cleocin Pediatric (Pro) 0 reviews Add rating

Cleocin Phosphate (Pro)

1. Drug Classes
2. Anti-infectives
3. Macrolide Derivatives
Print Share
Macrolide derivatives
What are Macrolide derivatives?
Macrolide derivatives are either macrolide antibiotics or other antibiotics related
to macrolides.
Macrolides are a class of antibiotics found in streptomycetes. They are natural

lactones with a large ring, consisting of 14 to 20 atoms. Macrolides bind to the
50S subunit of the bacterial ribosome and inhibit ribosomal translocation, leading
to inhibition of bacterial protein synthesis. Their action is primarily bacteriostatic
but may be bactericidal at high concentrations, or depending on the type of
microorganism.
What are Ketolides?

Ketolides are a new generation of macrolide antibiotics designed to overcome
issues with bacterial resistance to macrolides. They are semi-synthetic antibiotics
derived from erythromycin (macrolide antibiotic) and the changes give ketolides
a broader spectrum of activity.
Ketolides bind to the bacterial 50S ribosomal subunit and inhibit RNA-dependent
protein synthesis. They are bacteriostatic at low concentrations and bactericidal
at high concentration, so basically exhibit concentration dependent killing.
Ketolides have good antibacterial activity against Gram-positive bacteria such as

those that cause respiratory tract infections.
List of Ketolides:
Filter by:
Ketek (Pro) 0 reviews Add rating

Generic name: telithromycin
Ketek Pak
Generic name: telithromycin
What are Macrolides?

Macrolides are a class of antibiotics derived from Saccharopolyspora
erythraea (originally called Streptomyces erythreus), a type of soil-borne bacteria.
Macrolides inhibit protein synthesis in bacteria by reversibly binding to the P site

of the 50S unit of the ribosome. Macrolides mainly affect gram-positive cocci and
intracellular pathogens such as mycoplasma, chlamydia, and legionella.
Erythromycin was the first macrolide discovered; other macrolides include
azithromycin, clarithromycin, and roxithromycin.
Their action is primarily bacteriostatic but may be bactericidal at high

concentrations, or depending on the type of microorganism.
List of Macrolides:
Filter by:
E.E.S.-400 1 review 10
Generic name: erythromycin
Zmax (Pro) 0 reviews 8.0

Generic name: azithromycin
Zithromax (Pro) 121 reviews 7.4

Biaxin XL 9 reviews 7.2

Generic name: clarithromycin
Erythrocin (Pro) 3 reviews 7.2

Azithromycin Dose Pack 55 reviews 7.0

Ery-Tab (Pro) 1 review 7.0

Dificid (Pro) 5 reviews 6.8

Generic name: fidaxomicin
Biaxin (Pro) 85 reviews 6.4

Generic name: clarithromycin
E.E.S. Granules (Pro) 0 reviews Add rating

Eryc (Pro) 0 reviews Add rating

EryPed (Pro) 0 reviews Add rating

Erythrocin Lactobionate 0 reviews Add rating

Ilosone 0 reviews Add rating

PCE Dispertab (Pro)

1. Drug Classes
2. Anti-infectives
3. Sulfonamides
Print Share
Sulfonamides
Other names: sulfa drugs, sulphonamides
What are Sulfonamides?

Sulfonamides (sulphonamides) are a group of man-made (synthetic) medicines
that contain the sulfonamide chemical group. They may also be called sulfa
drugs.
Many people use the term sulfonamide imprecisely to refer only to antibiotics
that have a sulfonamide functional group in their chemical structure. However,
there are several non-antibiotic sulfonamides that have been developed by
exploiting observations made during the clinical evaluation of the antibiotic
sulfonamides. These are used for a range of conditions such as diabetes and pain
relief.
Sulfanilamide was the first sulfonamide developed in 1906, although it was not
used as an antimicrobial agent until the late 1930s. Sulfonamide antimicrobials
are bacteriostatic (stop bacteria from reproducing but don't necessarily kill them)
and work by interfering with the synthesis of folic acid in bacteria, which is
essential for nucleic acid formation and ultimately DNA and RNA. Humans obtain
folic acid from their diet, but bacteria need to synthesize it. Sulfonamide
antimicrobials may be combined with trimethoprim to make them bactericidal
(kill bacteria), because trimethoprim acts on a different enzyme in the folic acid
synthesis pathway.
Non-antibiotic sulfonamides are thought to have anti-inflammatory or

immunomodulatory properties although the exact way they work in some
conditions is not known.
What are sulfonamides used for?

Sulfonamides represent a diverse range of medicines with a diverse range of
actions. Examples of some conditions that may be treated with sulfonamides
include:
 Bacterial infections: eg, sulfamethoxazole/trimethoprim, sulfisoxazole
 Crohn’s disease: eg, sulfasalazine
 Diabetes: eg, glyburide, tolbutamide
 Fluid retention: eg, chlorothiazide, furosemide, hydrochlorothiazide
 Gout: eg, probenecid
 High blood pressure: eg, chlorothiazide, hydrochlorothiazide
 Pain and inflammation: eg, celecoxib
 Rheumatoid arthritis: eg, sulfasalazine
 Ulcerative colitis: eg, sulfasalazine.

sulfonamides?
Sulfonamide antibiotics have an N4 amine group in their structure which is
thought to contribute to their higher incidence of allergic-type reactions. Non-
antibiotic sulfonamides lack this structure.
Sulfonamide antibiotics
Oral sulfonamides are rapidly excreted and very soluble in urine and are
commonly used to treat infections of the urinary tract.
sulfacetamide topical Klaron, Ovace
sulfadiazine Generic only
sulfamethoxazole/trimethoprim Bactrim, Septa, SMZ-TMP
sulfisoxazole Gantrisin Pediatric, Truxazole
Non-antibiotic sulfonamides
Many classes of drugs contain a sulfonamide structure including carbonic
anhydrase inhibitors; sulfonylureas; and thiazide, thiazide-like and loop
diuretics.
acetazolamide Diamox
bumetanide Bumex
celecoxib Celebrex
chlorothiazide Diuril
chlorthalidone Thalitone
dapsone Generic
dorzolamide opthalmic Trusopt
furosemide Lasix
glibenclamide Not available in the U.S.
gliclazide Not available in the U.S.
glipizide Glucotrol
glyburide Micronase
hydrochlorothiazide (HCTZ) Aquazide H, Microzide
indapamide Lozol
probenecid Benemid
sulfasalazine* Azulfidine, Sulfazine
sumatriptan Imitrex
tolbutamide Orinase, Tol-tab
*Sulfasalazine also has an antibacterial effect.
Are sulfonamides safe?

Sulfonamide-containing drugs are frequently implicated in allergic and non-
allergic reactions.
The term “sulfa allergy” (or “sulfur allergy”) most commonly refers to an
immunological response to sulfonamides, and it is a term that is often misused
and misinterpreted. It should not be confused with a sulphite allergy (sulphites
are substances used to preserve foods); nor with an allergy to the element
sulphur or sulphates (allergic reactions to these naturally occurring substances
are extremely rare). Non-antibiotic sulfonamides are thought to be less likely than
antibiotic sulfonamides to cause severe allergic reactions.
Sulfonamide allergic reactions affect 1.5-3% of the population but are 10 times
more likely in people with HIV. Management depends on the type and severity of
the reaction. Mild reactions can be treated with drug discontinuation and
antihistamine administration. More severe reactions may require topical or oral
steroids and possibly hospital admission.
Sulfonamide allergies can manifest in several different ways, for example as:
 Sulfonamide drug hypersensitivity syndrome: Symptoms usually start 7 to
14 days after sulfonamide initiation and include fever and a generalized
rash; internal organs may be affected
 Fixed drug eruptions: Symptoms develop within 30 minutes to 8 hours of
taking the drugs and include well-defined, round or oval patches of
redness and skin swelling, sometimes surmounted by a blister
 Type I immediate, IgE-mediated, true allergic response: Hives occur within
30 minutes of drug administration. Anaphylaxis is rare
 Stevens-Johnson Syndrome (SJS) / Toxic Epidermal Necrolysis (TEN):
Serious, potentially fatal skin reaction that usually develops within the first
week of taking the drug. Symptoms include sheets of skin detachment
exposing red, oozing dermis
 Erythema nodosum: Symptoms include red, hot and painful lumps on the
shins or about the knees and ankles, often associated with joint pains or
fever
 Erythema multiforme: Symptoms include the appearance of skin lesions
that look like targets (show three concentric zones of color). May involve
any body site and the lips.
Sulfonamides may also rarely cause changes in the blood such as anemia
(destruction of red blood cells), leukopenia (destruction of white blood cells), and
other hematological side effects.
Renal side effects have been reported with sulfonamide use; more commonly
crystals in the urine (risk is higher in people who are dehydrated) and, rarely,
interstitial nephritis and tubular necrosis.
Note: Sulphites or drugs with a sulfhydryl or sulfate group in their structure (eg,
captopril, morphine sulfate, heparin sulfate) do not need to be avoided by people
with a sulfonamide allergy.
monographs.
What are the side effects of sulfonamides?

Common side effects reported with sulfonamides include:
 Gastrointestinal effects (such as diarrhea, nausea, stomach
upset, vomiting)
 Candidiasis (overgrowth of the yeast Candida causing conditions such as
thrush) (sulfonamide antibiotics)
 Dizziness
 Fatigue
 Folate deficiency
 Headaches
 Itchy skin
 Rash.
monographs.
List of Sulfonamides:
Filter by:
Drug Name Reviews Avg. Rating
Co-trimoxazole (Pro) 2 reviews 9.0

Generic name: sulfamethoxazole / trimethoprim
Sulfatrim (Pro) 5 reviews 6.7

Septra (Pro) 17 reviews 6.5

Septra DS 23 reviews 6.3

Bactrim (Pro) 417 reviews 5.7

Drug Name Reviews Avg. Rating
Bactrim DS 304 reviews 5.2

Sulfatrim Pediatric 1 review 1.0

Cotrim 0 reviews Add rating

Gantrisin 0 reviews Add rating

Generic name: sulfisoxazole
Gantrisin Pediatric 0 reviews Add rating

Truxazole
1. Drug Classes
2. Anti-infectives
3. Glycopeptide Antibiotics
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Glycopeptide antibiotics
What are Glycopeptide antibiotics?

Glycopeptide antibiotics are a type of antibiotic that inhibits bacterial cell wall
formation by inhibiting peptidoglycan synthesis. They are used for treating multi-
resistant Staphylococcus aureus (MRSA) infections and enterococcal infections,
which are resistant to beta-lactams and other antibiotics. They are also used in
cases where there is an allergy to beta-lactams.
What are glycopeptide antibiotics used for?

Glycopeptide antibiotics are usually reserved for the treatment of serious
infections caused by MRSA, Streptococcus, or Enterococcus bacteria which are
resistant to beta-lactams and other antibiotics, such as
 Clostridium difficile-associated diarrhea

 Endocarditis
 Enterocolitis
 Pneumonia acquired during a hospital stay or that develops while using a
ventilator
 Severe skin and skin structure infections
 Other serious infections that are not susceptible to other antibiotics.

glycopeptide antibiotics?
Vancomycin was the first glycopeptide antibiotic approved. The other three
glycopeptides available in the U.S. (dalbavancin, oritavancin, and telavancin)
are structurally related to vancomycin and were developed to improve on
vancomycin’s duration of action and tolerability. However, reports suggest that
one glycopeptide, telavancin, is no more effective than vancomycin and has more
adverse effects.
None are absorbed orally, although vancomycin is effective when given orally for
the treatment of Clostridium difficile-associated diarrhea because this infection is
localized in the gut. Vancomycin and telavancin are given once daily, whereas
dalbavancin is given once weekly or as a single infusion, and oritavancin as a
single infusion.
The need for monitoring in patients receiving vancomycin is controversial, and
the manufacturer does not consider it necessary. There is not considered any
value in monitoring the other glycopeptides.
dalbavancin Dalvance
oritavancin Orbactiv
teicoplanin Not approved in the U.S.
telavancin Vibativ
vancomycin oral, vancomycin injection Vancocin HCL pulvules
Are glycopeptide antibiotics safe?

Vancomycin and telavancin may affect kidney function; the risk is greatest in
those older than 65 years. Monitoring of kidney function during and immediately
following treatment may be required. Studies have reported that telavancin
causes more renal adverse effects than vancomycin.
Telavancin can interfere with some clotting tests and can cause prolongation of
the QT interval (the measurement on an ECG that represents electrical
depolarization and repolarization of the ventricles).
Glycopeptides may be ototoxic (toxic to the auditory nerve, cochlear, or

vestibular system of the ear). This may cause transient or permanent hearing
loss. The risk is highest in people given large intravenous doses, with pre-existing
hearing loss, or receiving another ototoxic agent, such as gentamicin.
Rarely, "Red Man Syndrome" has been associated with vancomycin IV and
dalbavancin. Symptoms include flushing of the upper body, shortness of breath,
a skin rash, itching, pain, muscle spasms and low blood pressure. Most
reactions resolve within 20 minutes; however, some may persist for several hours.

antibiotic, including glycopeptide antibiotics. Symptoms include severe diarrhea.
monographs.
What are the side effects of glycopeptide

antibiotics?
Side effects that have been reported with glycopeptide antibiotics include:
 Abdominal pain
 Back pain
 Diarrhea
 Edema
 Flatulence
 Foamy urine
 A headache
 Infusion reactions
 Itchy skin
 Low potassium levels
 Nausea
 Rash
 Taste disturbance
 Urinary tract infection
 Vomiting.
monographs.
List of Glycopeptide antibiotics:

Filter by:
Vancocin HCl 1 review 10

Generic name: vancomycin
Vancocin (Pro) 1 review 8.0

Dalvance (Pro) 1 review 1.0

Generic name: dalbavancin
Orbactiv (Pro) 2 reviews 1.0

Generic name: oritavancin
Firvanq (Pro) 0 reviews Add rating

Vancocin HCl Pulvules 0 reviews Add rating

Vibativ (Pro)
Generic name: telavancin
Aminoglycosides
What are Aminoglycosides?
Aminoglycosides are a class of antibiotics used mainly in the treatment of aerobic
gram-negative bacilli infections, although they are also effective against other
bacteria including Staphylococci and Mycobacterium tuberculosis. They are
often used in combination with other antibiotics.
Aminoglycosides are thought to work by inhibiting protein synthesis inside

bacteria. Kill rates of bacteria are increased when higher concentrations of
aminoglycosides are present; however, the margin between a safe and a toxic
dose is narrow and monitoring is often needed, although once daily dosing
increases the safety window. Impairment of kidney function and hearing loss are
the most common side effects of aminoglycosides. Aminoglycosides tend to be
used when other less toxic antibiotics are contraindicated or ineffective.
Aminoglycosides are not well absorbed when given by mouth, so need to be

given by injection by healthcare personnel.
List of Aminoglycosides:
Filter by:
Tobi (Pro) 0 reviews 9.0

Generic name: tobramycin
Garamycin 0 reviews 8.0

Generic name: gentamicin
Humatin (Pro) 2 reviews 4.0

Generic name: paromomycin
Amikin (Pro) 1 review 2.5

Generic name: amikacin
Amikin Pediatric 0 reviews Add rating

Generic name: amikacin
Arikayce 0 reviews Add rating

Generic name: amikacin liposome
Bethkis (Pro) 0 reviews Add rating

Kantrex (Pro) 0 reviews Add rating

Generic name: kanamycin
Kitabis Pak (Pro) 0 reviews Add rating

Nebcin 0 reviews Add rating

Neo-Fradin (Pro) 0 reviews Add rating

Generic name: neomycin
Neo-Tab 0 reviews Add rating

Generic name: neomycin
TOBI Podhaler (Pro) 0 reviews Add rating

Zemdri (Pro)
Generic name: plazomicin
What are Carbapenems?

Carbapenems are a class of beta-lactam antibiotic that are active against many
aerobic and anaerobic gram-positive and gram-negative organisms. Thienamycin
was the first carbapenem to be discovered in 1976. Carbapenems are notable for
their ability to inhibit beta-lactamase enzymes (also called penicillinase) - a type
of enzyme that greatly reduces the activity of antibiotics such as penicillins and
cephamycins. Of all the beta-lactam antibiotics, carbapenems possess the
broadest spectrum of activity and the greatest potency against bacteria. Because
of this, they are often reserved for more severe infections or used as "last-line"
agents.
Carbapenems inhibit bacterial cell wall synthesis by binding to the penicillin-

binding proteins and interfering with cell wall formation.
List of Carbapenems:
Filter by:
Doribax (Pro) 1 review 10

Generic name: doripenem
Merrem (Pro) 0 reviews 6.0

Generic name: meropenem
Invanz (Pro) 1 review 1.0

Generic name: ertapenem
Primaxin IM (Pro) 0 reviews Add rating

Generic name: cilastatin / imipenem
Primaxin IV (Pro)
Generic name: cilastatin / imipenem

Drug Classes

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1.

What are Cephalosporins?

What are cephalosporins used for?

What are the differences between

First generation cephalosporins

First generation cephalosporins refer to the first group of cephalosporins

Generic name Brand name examples

cefazolin Ancef, Kefzol

cephalexin Daxbia, Keflex

Second generation cephalosporins

Second-generation cephalosporins are more active against gram-negative

cefuroxime Ceftin, Zinacef

Third generation cephalosporins

Third generation cephalosporins followed the second-generation cephalosporins.

Cefotaxime and ceftizoxime (discontinued) offer the best gram-positive

All the third-generation cephalosporins except for cefoperazone (discontinued)

Generic name Brand name examples

ceftazidime Fortaz, Tazicef

Fourth generation cephalosporins

Fourth generation cephalosporins are structurally related to third-generation

Some fourth-generation cephalosporins have excellent activity against gram-

Cefepime is the only fourth generation cephalosporin available in the United

Generic name Brand name examples

Next (fifth) generation cephalosporins

Ceftaroline is currently the only next-generation cephalosporin available in the

Generic name Brand name examples

What are the side effects of cephalosporins?

Rarely, some people may develop a super-infection due to overgrowth of a

Uncommonly, an overgrowth of the yeast, Candida albicans, may occur following

View by: Brand | Generic

Drug Name Reviews Avg. Ratings

Avycaz (Pro) 0 reviews Add rating

First generation cephalosporins

What are First generation cephalosporins?

First generation cephalosporins refer to the first group of cephalosporins

What are first generation cephalosporins

What are the differences between first

Generic name Brand name examples

cefazolin Ancef, Kefzol

cephalexin Daxbia, Keflex

Are first generation cephalosporins safe?

Allergic reactions have been reported with cephalosporins (including first

What are the side effects of first generation

Rarely, some people may develop a super-infection due to overgrowth of a

Uncommonly, an overgrowth of the yeast, Candida albicans, may occur following

List of First generation cephalosporins:

View by: Brand | Generic

Duricef (Pro) 0 reviews 10

Kefzol 0 reviews 9.0

Keflex (Pro) 69 reviews 7.9

Ancef (Pro) 0 reviews 6.5

Biocef 0 reviews Add rating

What are Fourth generation

Cephalosporins are bactericidal (kill bacteria) and work in a similar way to

Fourth generation cephalosporins refer to the fourth group of cephalosporins

Some fourth-generation cephalosporins have excellent activity against gram-

Cefepime is the only fourth generation cephalosporin available in the United

List of Fourth generation cephalosporins:

View by: Brand | Generic

Drug Name Reviews Avg. Ratings

4. Next Generation Cephalosporins

Next generation cephalosporins

Other names: fifth generation cephalosporins, next-generation cephalosporins

What are Next generation cephalosporins?