Aminoglycoside

Use: Severe systemic infections from gram - organisms; Topical for wounds

Spectrum: Gram - enteric bacteria/suspicion of sepsis; P aeruginosa; Gram - rods (Enterobacteriaceae, Proteus, Pseudomonas, and Serratia); inactive against streptococci (including pneumococci), clostridia, bacteroides, Rickettsia, fungi, viruses

Mechanism: inhibits 30S sub-units which = Blocks initiation of protein synthesis, blocks further translation and elicits premature termination, incorptoration of incorrect AA

Tox: Nephrotoxicity, ototoxicity, neruomuscular weakness

Aminoglycoside

Use: Gonorrhea (ceftriaxone shot is used now)

Tetracycline

Indications: Mycoplasmapneumoniae, chlamydiae, rickettsiae, and some spirochetes – not for syphilis; Helicobacter pylori ( in combination with metronidazole and bismuth); various gram-positive and gram negative bacterial infections; gonococcal infections; chlamydial infections; plague, tularemia, brucellosis; entamoeba histolytica; plasmodium falciparum

Mechanism: Binds 30S ribosomes, preventing tRNA from binding receptor site on mRNA; Inhibits bacterial protein synthesis; bacteriostatic

Bacterial spectrum: amoebiasis, Plasmodium falciparum, bacillary dysentery (Shigella); many others, Gram + and Gram -; Francisella, tularensis, Pseudomonas, Vibrio cholerae, V fetus, H ducreyi, Mycoplsama pneumoniae, all rickettsial infections, borrelia novyi, B recurrentis, chlamydia, brucellosis, granuloma inguinale, yersinia pestis

Resistance mechanism: Mutants transport drug out of the cell

Adverse Rxn: Overgrowth of resistant flora (Candida), dental discoloration, DON'T GIVE TO PREGNANT WOMEN AND CHILDREN UNDER 8 (binds calcium in bones/teeth); Liver damage, renal damage (fanconi syndrome aka renal tubular acidosis), photosensitization

Other Drugs: Demeclocycline (Declomycin®) - inhibits ADH

Glycylcycline

Minocycyline derivative

IV abx

Mechanism: binds 30S subunit, bacteriostatic

Spectrum: like tetracycline, and also MRSA, PRSP (penicillin resistnat strept pneumo) and VRE (vanco recisistant enterococci)

Broad Spec Abx

Uses: Rarely used due to toxicity; not a DOC for any bacterial infection; Typhoid fever, meningitis, eye infections, gram - organisms, rickettsia, brucellosis, rocky mountain spotted fever

Mechanism: Reversibly binds 50S subunit, bacteriostatic; Inhibits peptide bond formation; bacteriostatic

Spectrum: H. influenza, Neisseria, meningitidis, Streptococcus pneumoniae; E. coli, aerobacter, proteus, rickettsia, brucellosis, Rocky mountain spotted fever

Bacterial resistaince: via acetyltransferase acetylation of dx; resistance can be passed; binding site mod; competition for binding site; transport removal of dx

Not effective against entamoeba histolytica or Pseudomonas

Tox: blood dyscrasias

PHK: metabolized in liver (90%), 10% removed in kidney

Tox: bone marrow depression, fatal aplastic anemia, allergy, gray baby syndrome; toxicities result from inhibition of protein synthesis in host mitochondria

Dx interactions: DON'T USE WITH penicillins, cephalosporins, aminoglycosides due to decreased effectiveness

Combo Broad Spec Abx

Misc Abx

Use: Anaerobic infections including RTI, bone and joint infections, septicemia, endocarditis, dental infections, pseudomembranous colitis

Adverse: disulfram-like effect

Misc Abx

Use: C. Diff: narrow spectrum gram+ aerobes and anaerobes; no activity against gram - bacteria

Misc Abx

Use: impetigo from S. aureus and beta-hemolytic strep i.e. strep pyogenes

Bacteriostatic at low concentrations, bactericidal at high concentrations

Misc Abx: polypeptide abx

Use: gram - infections; burns, wounds, UTI, septicemia, 

Mechanism: binds gram - cell membrane phospholipids, increases permeability and loss of metabolites

Tox: nephrotoxicity