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Antibiotics are substances that are derived from various species of microorganisms and are capable of
inhibiting the growth of other microorganisms when administered in small concentrations. Antimicrobial
agents that are produced synthetically but have action similar to that of antibiotics have been defined as
chemotherapeutic agents (sulphonamides, quinolones ).
Various antibiotics act on different sites of bacteria and some agents have more than one primary site of
action or mechanism by which bacteria are destroyed.
The Penicillins
Penicillins and cephalosporins act by inhibiting transpeptidases, the enzyme that catalyzes the final cross
linking step in synthesis of peptidoglycan. In non-growing cells, no new cross-linkages are required and
penicillin is inactive. An intact beta-lactam is essential for the antibacterial activity of the penicillin.
Classification of Penicillins
Natural
· Benzylpenicillin (penicillin G)
· Phenoxymethyl penicillin (penicillin V)
Semisynthetic and penicillinase resistant
· Methicillin
· N afcillin
· Cloxacillin
· Oxacillin
· Dicloxacillin
· Floxacillin
Extended spectrum
. Aminopenicillins
- Ampicillin
- Amoxycillin
Carboxypenicillins
- Carbenicillin
- Ticracillin
Ureidopenicillin
- Piperacillin
Resistance to penicillin is mainly due to the modification of the antibiotic by the enzyme beta lactamase or
penicillin amidase, commonly called as penicillinase. The enzyme penicillinase is found both in Gram
positive and Gram negative organisms.
Beta Ladamase Inhibitors: The activity of beta lactamase can be inhibited by clavulinic acid which is a
product of Strept.clavuligerus. This is a semisynthetic sulfone derivative with weak antibacterial activity of
its own. It acts best when administered in combination with ampicillin.
Tazobactam; This is a penicillonic acid sulfone derivative. It gives best results when used in combination
with piperacillin.
Cephalosporins are also beta-Iactam drugs that act in the same manner as penicillins. The structures,
however, are different. Cephalopsorins are the products of molds of genus Cephalosporium, except
cefoxilin which is produced from Streptomyces.
ANTIFUNGAL DRUGS
Polyenes: Two commonly used antifungal drugs that belong to this group are nystatin and amphotericin
B. Both are fungicidal. These drugs combine with the sterols in fungal plasma membranes, making the
membranes excessively permeable and killing the cell.
Imidazole: To this group belong miconazole, clotrimazole and ketaconazole which primarily interfere with
sterol synthesis in fungi.
Griseofulvin: This antifungal agent is produced by Penicillium species. It has the property of binding
selectively to keratin found in the skin, hair follicles and nails. Its mode of action is to interfere with
mitosis and thereby inhibiting fungal reproduction.
DRUG RESISTANCE
Origin of Drug Resistant Strains
The drug resistant strains arise either by mutation and selection or by genetic exchange in which a
sensitive organism receives the genetic material (part of DNA) from the resistant organism and the part of
DNA carries with it the information of mode of inducing resistance against one or multiple antimicrobial
agents. The drug resistance can arise by random mutation and when with it the organism becomes
resistant to a drug, the application of that drug shall select out the resistant organisms and let them
multiply.
Transmissible (Infectious) Drug Resistance
Extrachromosomal material called plasmid (or episome) is also capable of conferring resistance to
antibiotics. There is adequate evidence to suggest that transfer of resistance can occur within the
intestinal tract of human beings as well as the animals.