Chemistry:List of antibiotics

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The following is a list of antibiotics. The highest division between antibiotics is bactericidal and bacteriostatic. Bactericidals kill bacteria directly, whereas bacteriostatics prevent them from dividing. However, these classifications are based on laboratory behavior. The development of antibiotics has had a profound effect on the health of people for many years. Also, both people and animals have used antibiotics to treat infections and diseases. In practice, both treat bacterial infections.[1]

By coverage

The following are lists of antibiotics for specific microbial coverage (not an exhaustive list):

MRSA

Antibiotics that cover methicillin-resistant Staphylococcus aureus (MRSA):

Pseudomonas aeruginosa

Antibiotics that cover Pseudomonas aeruginosa:

Certain cephalosporins, cephalosporin-beta-lactamase-inhibitor combinations, and new siderophore cephalosporins.

Certain penicillins:

  • Piperacillin and Piperacillin/tazobactam
  • Ticarcillin/clavulanic acid

Certain carbapenems and carbapenem-beta-lactamase-inhibitors combinations:

  • Carbapenems: (meropenem, imipenem/cilastatin, doripenem - NOT ertapenem)
  • Meropenem/vaborbactam
  • Imipenem/cilastatin/relebactam

Others:

  • Fluoroquinolones: particularly levofloxacin, ciprofloxacin
  • Polymyxins: Colistin, Polymyxin B
  • Aztreonam (monobactam)
  • Aminoglycosides - particularly tobramycin and amikacin

VRE

Antibiotics that usually have activity against vancomycin-resistant Enterococcus (VRE):

Antibiotics with less reliable but occasional (depending on isolate and subspecies) activity:

  • occasionally penicillins including penicillin, ampicillin and ampicillin-sulbactam, amoxicillin and amoxicillin-clavulnate, and piperacillin-tazobactam (not all vancomycin-resistant Enterococcus isolates are resistant to penicillin and ampicillin)
  • occasionally doxycycline and minocycline
  • occasionally fluoroquinolones such as moxifloxacin, levofloxacin, and ciprofloxacin

By class

See also pathogenic bacteria for a list of antibiotics sorted by target bacteria.

Antibiotics coverage diagram

Antibiotics by class
Generic name Brand names Common uses[4] Possible side effects[4] Mechanism of action
Aminoglycosides
Amikacin Amikin Infections caused by Gram-negative bacteria, such as Escherichia coli and Klebsiella particularly Pseudomonas aeruginosa. Effective against aerobic bacteria (not obligate/facultative anaerobes) and tularemia. All aminoglycosides are ineffective when taken orally as the stomach will digest the drug before it goes into the bloodstream. However aminoglycosides are effective in Intravenous, intramuscular and topical forms.
  • Hearing loss
  • Vertigo
  • Kidney damage
Binding to the bacterial 30S ribosomal subunit (some work by binding to the 50S subunit), inhibiting the translocation of the peptidyl-tRNA from the A-site to the P-site and also causing misreading of mRNA, leaving the bacterium unable to synthesize proteins vital to its growth.
Gentamicin Garamycin
Kanamycin Kantrex
Neomycin Neo-Fradin[5]
Netilmicin Netromycin
Tobramycin Nebcin
Paromomycin Humatin
Streptomycin Tuberculosis
Spectinomycin(Bs) Trobicin Gonorrhea
Ansamycins
Geldanamycin Experimental, as antitumor antibiotics Block DNA transcription, either via inhibiting DNA-dependent RNA polymerase by binding to the β-subunit
Herbimycin
Rifaximin Xifaxan Traveler's diarrhea caused by E. coli
Carbacephem
Loracarbef Lorabid Discontinued Prevents bacterial cell division by inhibiting cell wall synthesis.
Carbapenems
Ertapenem Invanz Bactericidal for both Gram-positive and Gram-negative organisms and therefore useful for empiric broad-spectrum antibacterial coverage. (Notes: MRSA resistance to this class. All are active against Pseudomonas aeruginosa except ertapenem.)
  • Gastrointestinal upset and diarrhea
  • Nausea
  • Seizures
  • Headache
  • Rash and allergic reactions
Inhibition of cell wall synthesis
Doripenem Doribax
Imipenem/Cilastatin Primaxin
Meropenem Merrem
Cephalosporins (First generation)
Cefadroxil Duricef Good coverage against Gram-positive infections.
  • Gastrointestinal upset and diarrhea
  • Nausea (if alcohol taken concurrently)
  • Allergic reactions
Same mode of action as other beta-lactam antibiotics: disrupt the synthesis of the peptidoglycan layer of bacterial cell walls.
Cefazolin Ancef, Kefzol
Cephradine
Cephapirin
Cephalothin
Cefalexin Keflex
Cephalosporins (Second generation)
Cefaclor Distaclor, Ceclor, Raniclor Less Gram-positive cover, improved Gram-negative cover.
  • Gastrointestinal upset and diarrhea
  • Nausea (if alcohol taken concurrently) - if contains methylthiotetrazole side group
  • Hypoprothrombinemia - if contains methylthiotetrazole side group
  • Allergic reactions
Same mode of action as other beta-lactam antibiotics: disrupt the synthesis of the peptidoglycan layer of bacterial cell walls.
Cefoxitin
Cefotetan Cefotan
Cefamandole
Cefmetazole
Cefonicid
Loracarbef
Cefprozil Cefzil
Cefuroxime Ceftin, Zinacef (UK)
Cephalosporins (Third generation)
Cefixime (antagonistic with Chloramphenicol)[6] Cefspan (Fujisawa), Suprax Improved coverage of Gram-negative organisms, except Pseudomonas. Reduced Gram-positive cover. But still not cover Mycoplasma and Chlamydia
  • Gastrointestinal upset and diarrhea
  • Nausea (if alcohol taken concurrently)
  • Allergic reactions
Same mode of action as other beta-lactam antibiotics: disrupt the synthesis of the peptidoglycan layer of bacterial cell walls.
Cefdinir Omnicef, Cefdiel
Cefditoren Spectracef, Meiact
Cefoperazone [Unlike most third-generation agents, cefoperazone is active against Pseudomonas aeruginosa], combination Cefoperazone with Sulbactam makes more effective antibiotic, because Sulbactam avoid degeneration of Cefoperazone Cefobid (discontinued)
Cefotaxime Claforan
Cefpodoxime Vantin, Banadoz
Ceftazidime (Unlike most third-generation agents, ceftazidime is active against Pseudomonas aeruginosa, but less active against Staphylococci and Streptococci compare to other 3rd generation of cephalosporins) Fortaz, Ceptaz
Ceftibuten Cedax
Ceftizoxime
Moxalactam
Ceftriaxone (IV and IM, not orally, effective also for syphilis and uncomplicated gonorrhea) Rocephin
Cephalosporins (Fourth generation)
Cefepime Maxipime

Covers pseudomonal infections.

  • Gastrointestinal upset and diarrhea
  • Nausea (if alcohol taken concurrently)
  • Allergic reactions
Same mode of action as other beta-lactam antibiotics: disrupt the synthesis of the peptidoglycan layer of bacterial cell walls.
Cephalosporins (Fifth generation)
Ceftaroline fosamil Teflaro Used to treat MRSA
  • Gastrointestinal upset and diarrhea
  • Allergic reaction
Same mode of action as other beta-lactam antibiotics: disrupt the synthesis of the peptidoglycan layer of bacterial cell walls.
Ceftobiprole Zeftera Used to treat MRSA (methicillin-resistant Staphylococcus aureus), penicillin-resistant Streptococcus pneumoniae, Pseudomonas aeruginosa, and enterococci
  • Gastrointestinal upset and diarrhea
  • Nausea (if alcohol taken concurrently)
  • Allergic reactions
Same mode of action as other beta-lactam antibiotics: disrupt the synthesis of the peptidoglycan layer of bacterial cell walls.
Glycopeptides
Teicoplanin Targocid (UK) Active against aerobic and anaerobic Gram-positive bacteria including MRSA; Vancomycin is used orally for the treatment of C. difficile colitis Inhibits peptidoglycan synthesis.
Vancomycin Vancocin
Telavancin Vibativ
Dalbavancin Dalvance
Oritavancin Orbactiv
Lincosamides(Bs)
Clindamycin Cleocin Serious staph-, pneumo-, and streptococcal infections in penicillin-allergic patients, also anaerobic infections; clindamycin topically for acne Possible C. difficile-related pseudomembranous enterocolitis Binds to 50S subunit of bacterial ribosomal RNA thereby inhibiting protein synthesis.
Lincomycin Lincocin
Lipopeptide
Daptomycin Cubicin Gram-positive organisms, but is inhibited by pulmonary surfactant so less effective against pneumonias Binds to the membrane and cause rapid depolarization, resulting in a loss of membrane potential leading to inhibition of protein, DNA and RNA synthesis.
Macrolides(Bs)
Azithromycin Zithromax, Sumamed, Xithrone Streptococcal infections, syphilis, upper respiratory tract infections, lower respiratory tract infections, mycoplasmal infections, Lyme disease
  • Nausea, vomiting, and diarrhea (especially at higher doses)
  • Prolonged cardiac QT interval (especially erythromycin)
  • Hearing loss (especially at higher doses)
  • Jaundice
Inhibition of bacterial protein biosynthesis by binding reversibly to the subunit 50S of the bacterial ribosome, thereby inhibiting translocation of peptidyl tRNA.
Clarithromycin Biaxin
Erythromycin Erythocin, Erythroped
Roxithromycin
Telithromycin Ketek Pneumonia Visual disturbance, liver toxicity.[7]
Spiramycin Rovamycine Mouth infections
Fidaxomicin Dificid Treatment of Clostridioides (formerly Clostridium) difficile infection.[8] May be more narrow-spectrum than vancomycin, resulting in less bowel microbiota alteration.[9] Nausea (11%), vomiting, and abdominal pain.[10] Bactericidal in susceptible organisms such as C. difficile by inhibiting RNA polymerase, thereby inhibiting protein synthesis.[10]
Monobactams
Aztreonam Azactam Gram-negative bacteria Same mode of action as other beta-lactam antibiotics: disrupt the synthesis of the peptidoglycan layer of bacterial cell walls.
Nitrofurans
Furazolidone Furoxone Bacterial or protozoal diarrhea or enteritis
Nitrofurantoin(Bs) Macrodantin, Macrobid Urinary tract infections
Oxazolidinones(Bs)
Linezolid Zyvox VRSA Protein synthesis inhibitor; prevents the initiation step
Posizolid Phase II clinical trials
Radezolid Phase II clinical trials
Tedizolid Sivextro
Penicillins
Amoxicillin Novamox, Amoxil Wide range of infections; penicillin used for streptococcal infections, syphilis, and Lyme disease
  • Gastrointestinal upset and diarrhea
  • Allergy with serious anaphylactic reactions
  • Brain and kidney damage (rare)
Same mode of action as other beta-lactam antibiotics: disrupt the synthesis of the peptidoglycan layer of bacterial cell walls.
Ampicillin Principen (discontinued)
Azlocillin
Dicloxacillin Dynapen (discontinued)
Flucloxacillin Floxapen (Sold to European generics Actavis Group)
Mezlocillin Mezlin (discontinued)
Methicillin Staphcillin (discontinued)
Nafcillin Unipen (discontinued)
Oxacillin Prostaphlin (discontinued)
Penicillin G Pentids (discontinued)
Penicillin V Veetids (Pen-Vee-K) (discontinued)
Piperacillin Pipracil (discontinued)
Penicillin G Pfizerpen
Temocillin Negaban (UK) (discontinued)
Ticarcillin Ticar (discontinued)
Penicillin combinations
Amoxicillin/clavulanate Augmentin Both Amoxicillin/clavulanate and Ampicillin/sulbactam are effective against non-recurrent acute otitis media.[11] Amoxicillin/clavulanate is one of the few oral antibiotics effective against skin and soft tissue infections. Can be given to children less than 40 kilograms in weight; for children heavier, the dosage is same as adults, twice daily.[12] The second component reduces the effectiveness of some forms of bacterial resistance to the first component
Ampicillin/sulbactam Unasyn
Piperacillin/tazobactam Zosyn
Ticarcillin/clavulanate Timentin
Polypeptides
Bacitracin Eye, ear or bladder infections; usually applied directly to the eye or inhaled into the lungs; rarely given by injection, although the use of intravenous colistin is experiencing a resurgence due to the emergence of multi drug resistant organisms. Kidney and nerve damage (when given by injection) Inhibits isoprenyl pyrophosphate, a molecule that carries the building blocks of the peptidoglycan bacterial cell wall outside of the inner membrane[13]
Colistin Coly-Mycin-S Interact with the Gram-negative bacterial outer membrane and cytoplasmic membrane, displacing bacterial counterions, which destabilizes the outer membrane. Act like a detergent against the cytoplasmic membrane, which alters its permeability. Polymyxin B and E are bactericidal even in an isosmotic solution.
Polymyxin B
Quinolones/Fluoroquinolones
Ciprofloxacin Cipro, Ciproxin, Ciprobay Urinary tract infections, bacterial prostatitis, community-acquired pneumonia, bacterial diarrhea, mycoplasmal infections, gonorrhea Nausea (rare), irreversible damage to central nervous system (uncommon), tendinosis (rare) Inhibits the bacterial DNA gyrase or the topoisomerase IV enzyme, thereby inhibiting DNA replication and transcription.
Enoxacin Penetrex
Gatifloxacin Tequin
Gemifloxacin Factive[14]
Levofloxacin Levaquin
Lomefloxacin Maxaquin
Moxifloxacin Avelox
Nadifloxacin
Nalidixic acid NegGram
Norfloxacin Noroxin
Ofloxacin Floxin (discontinued), Ocuflox
Trovafloxacin Trovan Withdrawn
Grepafloxacin Raxar Withdrawn
Sparfloxacin Zagam Withdrawn
Temafloxacin Omniflox Withdrawn
Sulfonamides(Bs)
Mafenide Sulfamylon Urinary tract infections (except sulfacetamide, used for eye infections, and mafenide and silver sulfadiazine, used topically for burns)
  • Nausea, vomiting, and diarrhea
  • Allergy (including skin rashes)
  • Crystals in urine
  • Kidney failure
  • Decrease in white blood cell count
  • Sensitivity to sunlight
Folate synthesis inhibition. They are competitive inhibitors of the enzyme dihydropteroate synthetase, DHPS. DHPS catalyses the conversion of PABA (para-aminobenzoate) to dihydropteroate, a key step in folate synthesis. Folate is necessary for the cell to synthesize nucleic acids (nucleic acids are essential building blocks of DNA and RNA), and in its absence cells cannot divide.
Sulfacetamide Sulamyd, Bleph-10
Sulfadiazine Micro-Sulfon
Silver sulfadiazine Silvadene
Sulfadimethoxine Di-Methox, Albon
Sulfamethizole Thiosulfil Forte
Sulfamethoxazole Gantanol
Sulfanilimide (archaic)
Sulfasalazine Azulfidine
Sulfisoxazole Gantrisin
Trimethoprim-Sulfamethoxazole (Co-trimoxazole) (TMP-SMX) Bactrim, Septra
Sulfonamidochrysoidine (archaic) Prontosil
Tetracyclines(Bs)
Demeclocycline Declomycin Syphilis, chlamydial infections, Lyme disease, mycoplasmal infections, acne rickettsial infections, malaria[note 1]
  • Gastrointestinal upset
  • Sensitivity to sunlight
  • Potential toxicity to mother and fetus during pregnancy
  • Enamel hypoplasia (staining of teeth; potentially permanent)
  • Transient depression of bone growth
Inhibits the binding of aminoacyl-tRNA to the mRNA-ribosome complex. They do so mainly by binding to the 30S ribosomal subunit in the mRNA translation complex. But Tetracycline cannot be taken together with all dairy products, aluminium, iron and zinc minerals.
Doxycycline Vibramycin
Metacycline
Minocycline Minocin
Oxytetracycline Terramycin
Tetracycline Sumycin, Achromycin V, Steclin
Drugs against mycobacteria
Clofazimine Lamprene Antileprotic
Dapsone Avlosulfon Antileprotic
Capreomycin Capastat Antituberculosis
Cycloserine Seromycin Antituberculosis, urinary tract infections
Ethambutol(Bs) Myambutol Antituberculosis
Ethionamide Trecator Antituberculosis Inhibits peptide synthesis
Isoniazid I.N.H. Antituberculosis
Pyrazinamide Aldinamide Antituberculosis
Rifampicin (Rifampin in US) Rifadin, Rimactane mostly Gram-positive and mycobacteria Reddish-orange sweat, tears, and urine Binds to the β subunit of RNA polymerase to inhibit transcription
Rifabutin Mycobutin Mycobacterium avium complex Rash, discolored urine, GI symptoms
Rifapentine Priftin Antituberculosis
Streptomycin Antituberculosis Neurotoxicity, ototoxicity As other aminoglycosides
Others
Arsphenamine Salvarsan Spirochaetal infections (obsolete)
Chloramphenicol(Bs) Chloromycetin Meningitis, MRSA, topical use, or for low-cost internal treatment. Historic: typhus, cholera. Gram-negative, Gram-positive, anaerobes Rarely: aplastic anemia. Inhibits bacterial protein synthesis by binding to the 50S subunit of the ribosome
Fosfomycin Monurol, Monuril Acute cystitis in women This antibiotic is not recommended for children and 75 and up of age Inactivates enolpyruvyl transferase, thereby blocking cell wall synthesis
Fusidic acid Fucidin
Metronidazole Flagyl Infections caused by anaerobic bacteria; also amoebiasis, trichomoniasis, giardiasis Discolored urine, headache, metallic taste, nausea; alcohol is contraindicated Produces toxic free radicals that disrupt DNA and proteins. This non-specific mechanism is responsible for its activity against a variety of bacteria, amoebae, and protozoa.
Mupirocin Bactroban Ointment for impetigo, cream for infected cuts Inhibits isoleucine t-RNA synthetase (IleRS) causing inhibition of protein synthesis
Platensimycin
Quinupristin/Dalfopristin Synercid
Thiamphenicol Gram-negative, Gram-positive, anaerobes. Widely used in veterinary medicine. Rash. Lacks known anemic side-effects. A chloramphenicol analog. May inhibit bacterial protein synthesis by binding to the 50S subunit of the ribosome
Tigecycline(Bs) Tigacyl Slowly Intravenous. Indicated for complicated skin/skin structure infections, soft tissue infections and complicated intra-abdominal infections. Effective for gram-positive, gram-negative, anaerobic, and against multi-antibiotic resistant bacteria (such as Staphylococcus aureus [MRSA] and Acinetobacter baumannii), but not effective for Pseudomonas spp. and Proteus spp. Teeth discoloration and same side effects as tetracycline. Not to be given for children and pregnant or lactate women. Relatively safe and no need dose adjusted when be given for mild to moderate liver function or renal patients Similar structure with tetracycline, but five times stronger, big volume distribution and long half-time in the body
Tinidazole Tindamax Fasigyn Protozoal infections Upset stomach, bitter taste, and itchiness
Trimethoprim(Bs) Proloprim, Trimpex Urinary tract infections
Generic Name Brand Names Common Uses[4] Possible Side Effects[4] Mechanism of action

Note: (Bs): Bacteriostatic

Antibiotic candidates

These are antibiotic candidates, and known antibiotics that are not yet mass-produced.

Antibiotic candidates
Generic name Origin Susceptible phyla Stage of development Mechanism of action
Unclassified
Teixobactin Eleftheria terrae Gram-positive, including antibiotic resistant S. aureus and M. tuberculosis No human trials scheduled Binds fatty acid precursors to cell wall
Malacidins Uncultured Bacterium Gram-positive, including antibiotic resistant S. aureus No human trials scheduled Binds fatty acid precursors to cell wall
Halicin Anti-diabetic drug Clostridiodes difficile, Acinetobacter baumannii, and Mycobacterium tuberculosis No human trials scheduled Disrupts electrochemical gradient

See also

Notes

  1. Note: Malaria is caused by a protist and not a bacterium.

References

  1. Pelczar, M. J.; Chan, E. C. S. and Krieg, N. R. (1999) "Host-Parasite Interaction; Nonspecific Host Resistance", In: Microbiology Concepts and Applications, 6th ed., McGraw-Hill Inc., New York pp. 478-479.
  2. 2.0 2.1 2.2 2.3 Aoki, Makoto (2015). レジデントのための感染症診療マニュアル. Japan: 医学書院. ISBN 978-4-260-02027-5. 
  3. "Ceftobiprole: a review of a broad-spectrum and anti-MRSA cephalosporin". American Journal of Clinical Dermatology 9 (4): 245–54. 2008. doi:10.2165/00128071-200809040-00004. PMID 18572975. 
  4. 4.0 4.1 4.2 4.3 For common Uses and possible side effects reference is: Robert Berkow (ed.) The Merck Manual of Medical Information - Home Edition. Pocket (September 1999), ISBN:0-671-02727-1.
  5. "Neomycin Drug Information". uptodate. http://www.uptodate.com/contents/neomycin-drug-information?source=search_result&search=neomycin&selectedTitle=1~135. (Subscription content?)
  6. Berger, Dr. Stephen (2014-04-03). GIDEON Guide to Antimicrobial Agents (2014 ed.). GIDEON Informatics Inc. p. 221. ISBN 978-1-61755-839-9. https://books.google.com/books?id=p66RBQAAQBAJ&dq=aeromonas+hydrophila+cefixime&pg=PA221. Retrieved 4 February 2015. 
  7. Splete, Heidi; Kerri Wachter (March 2006). "Liver toxicity reported with Ketek". Internal Medicine News. 
  8. "Clinical Practice Guidelines for Clostridium difficile Infection in Adults and Children: 2017 Update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA)". Clinical Infectious Diseases 66 (7): e1–e48. March 2018. doi:10.1093/cid/cix1085. PMID 29462280. 
  9. "A new macrocyclic antibiotic, fidaxomicin (OPT-80), causes less alteration to the bowel microbiota of Clostridium difficile-infected patients than does vancomycin". Microbiology 156 (Pt 11): 3354–9. November 2010. doi:10.1099/mic.0.042010-0. PMID 20724385. 
  10. 10.0 10.1 Dificid (fidaxomicin) [prescribing information] Whitehouse Station, NJ: Merck; December 2015.
  11. "Amoxicillin-sulbactam versus amoxicillin-clavulanic acid for the treatment of non-recurrent-acute otitis media in Argentinean children". International Journal of Pediatric Otorhinolaryngology 69 (9): 1225–33. September 2005. doi:10.1016/j.ijporl.2005.03.016. PMID 16061111. 
  12. "APO-Amoxycillin and Clavulanic Acid 500mg/125 mg Tablets". http://www.betterhealth.vic.gov.au/bhcv2/bhcmed.nsf/pages/txcamoxy/$File/txcamoxy.pdf. 
  13. Mechanism of Action of Bacitracin: Complexation with Metal Ion and C55-Isoprenyl Pyrophosphate K. John Stone and Jack L. Strominger
  14. "List of Antibiotics". http://www.emedexpert.com/lists/antibiotics.shtml.