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:

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

Others:

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 nameBrand namesCommon uses[4]Possible side effects[4]Mechanism of action
Aminoglycosides
AmikacinAmikinInfections 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. 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.
GentamicinGaramycin
KanamycinKantrex
NeomycinNeo-Fradin[5]
NetilmicinNetromycin
TobramycinNebcin
ParomomycinHumatin
StreptomycinTuberculosis
Spectinomycin(Bs)TrobicinGonorrhea
Ansamycins
GeldanamycinExperimental, as antitumor antibiotics Block DNA transcription, either via inhibiting DNA-dependent RNA polymerase by binding to the β-subunit
Herbimycin
RifaximinXifaxanTraveler's diarrhea caused by E. coli
Carbacephem
LoracarbefLorabidDiscontinuedPrevents bacterial cell division by inhibiting cell wall synthesis.
Carbapenems
ErtapenemInvanzBactericidal 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
DoripenemDoribax
Imipenem/CilastatinPrimaxin
MeropenemMerrem
Cephalosporins (First generation)
CefadroxilDuricefGood 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.
CefazolinAncef, Kefzol
Cephradine
Cephapirin
Cephalothin
CefalexinKeflex
Cephalosporins (Second generation)
CefaclorDistaclor, Ceclor, RaniclorLess 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
CefotetanCefotan
Cefamandole
Cefmetazole
Cefonicid
Loracarbef
CefprozilCefzil
CefuroximeCeftin, Zinacef (UK)
Cephalosporins (Third generation)
Cefixime (antagonistic with Chloramphenicol)[6]Cefspan (Fujisawa), SupraxImproved 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.
CefdinirOmnicef, Cefdiel
CefditorenSpectracef, 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 CefoperazoneCefobid (discontinued)
CefotaximeClaforan
CefpodoximeVantin, 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
CeftibutenCedax
Ceftizoxime
Moxalactam
Ceftriaxone (IV and IM, not orally, effective also for syphilis and uncomplicated gonorrhea)Rocephin
Cephalosporins (Fourth generation)
CefepimeMaxipime

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 fosamilTeflaroUsed 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.
CeftobiproleZefteraUsed 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
TeicoplaninTargocid (UK)Active against aerobic and anaerobic Gram-positive bacteria including MRSA; Vancomycin is used orally for the treatment of C. difficile colitisInhibits peptidoglycan synthesis.
VancomycinVancocin
TelavancinVibativ
DalbavancinDalvance
OritavancinOrbactiv
Lincosamides(Bs)
ClindamycinCleocinSerious staph-, pneumo-, and streptococcal infections in penicillin-allergic patients, also anaerobic infections; clindamycin topically for acnePossible C. difficile-related pseudomembranous enterocolitisBinds to 50S subunit of bacterial ribosomal RNA thereby inhibiting protein synthesis.
LincomycinLincocin
Lipopeptide
DaptomycinCubicinGram-positive organisms, but is inhibited by pulmonary surfactant so less effective against pneumoniasBinds 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)
AzithromycinZithromax, Sumamed, XithroneStreptococcal 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.
ClarithromycinBiaxin
ErythromycinErythocin, Erythroped
Roxithromycin
TelithromycinKetekPneumoniaVisual disturbance, liver toxicity.[7]
SpiramycinRovamycineMouth 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
AztreonamAzactamGram-negative bacteriaSame mode of action as other beta-lactam antibiotics: disrupt the synthesis of the peptidoglycan layer of bacterial cell walls.
Nitrofurans
FurazolidoneFuroxoneBacterial or protozoal diarrhea or enteritis
Nitrofurantoin(Bs)Macrodantin, MacrobidUrinary tract infections
Oxazolidinones(Bs)
LinezolidZyvoxVRSA Protein synthesis inhibitor; prevents the initiation step
PosizolidPhase II clinical trials
RadezolidPhase II clinical trials
TedizolidSivextro
Penicillins
AmoxicillinNovamox, AmoxilWide 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.
AmpicillinPrincipen (discontinued)
Azlocillin
DicloxacillinDynapen (discontinued)
FlucloxacillinFloxapen (Sold to European generics Actavis Group)
MezlocillinMezlin (discontinued)
MethicillinStaphcillin (discontinued)
NafcillinUnipen (discontinued)
OxacillinProstaphlin (discontinued)
Penicillin GPentids (discontinued)
Penicillin VVeetids (Pen-Vee-K) (discontinued)
PiperacillinPipracil (discontinued)
Penicillin GPfizerpen
TemocillinNegaban (UK) (discontinued)
TicarcillinTicar (discontinued)
Penicillin combinations
Amoxicillin/clavulanateAugmentinBoth 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/sulbactamUnasyn
Piperacillin/tazobactamZosyn
Ticarcillin/clavulanateTimentin
Polypeptides
BacitracinEye, 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]
ColistinColy-Mycin-SInteract 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
CiprofloxacinCipro, Ciproxin, CiprobayUrinary tract infections, bacterial prostatitis, community-acquired pneumonia, bacterial diarrhea, mycoplasmal infections, gonorrheaNausea (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.
EnoxacinPenetrex
GatifloxacinTequin
GemifloxacinFactive[14]
LevofloxacinLevaquin
LomefloxacinMaxaquin
MoxifloxacinAvelox
Nadifloxacin
Nalidixic acidNegGram
NorfloxacinNoroxin
OfloxacinFloxin (discontinued), Ocuflox
TrovafloxacinTrovanWithdrawn
GrepafloxacinRaxarWithdrawn
SparfloxacinZagamWithdrawn
TemafloxacinOmnifloxWithdrawn
Sulfonamides(Bs)
MafenideSulfamylonUrinary tract infections (except sulfacetamide, used for eye infections, and mafenide and silver sulfadiazine, used topically for burns) 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.
SulfacetamideSulamyd, Bleph-10
SulfadiazineMicro-Sulfon
Silver sulfadiazineSilvadene
SulfadimethoxineDi-Methox, Albon
SulfamethizoleThiosulfil Forte
SulfamethoxazoleGantanol
Sulfanilimide (archaic)
SulfasalazineAzulfidine
SulfisoxazoleGantrisin
Trimethoprim-Sulfamethoxazole (Co-trimoxazole) (TMP-SMX)Bactrim, Septra
Sulfonamidochrysoidine (archaic)Prontosil
Tetracyclines(Bs)
DemeclocyclineDeclomycinSyphilis, 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.
DoxycyclineVibramycin
Metacycline
MinocyclineMinocin
OxytetracyclineTerramycin
TetracyclineSumycin, Achromycin V, Steclin
Drugs against mycobacteria
ClofazimineLampreneAntileprotic
DapsoneAvlosulfonAntileprotic
CapreomycinCapastatAntituberculosis
CycloserineSeromycinAntituberculosis, urinary tract infections
Ethambutol(Bs)MyambutolAntituberculosis
EthionamideTrecatorAntituberculosisInhibits peptide synthesis
IsoniazidI.N.H.Antituberculosis
PyrazinamideAldinamideAntituberculosis
Rifampicin (Rifampin in US)Rifadin, Rimactanemostly Gram-positive and mycobacteriaReddish-orange sweat, tears, and urineBinds to the β subunit of RNA polymerase to inhibit transcription
RifabutinMycobutinMycobacterium avium complexRash, discolored urine, GI symptoms
RifapentinePriftinAntituberculosis
StreptomycinAntituberculosisNeurotoxicity, ototoxicityAs other aminoglycosides
Others
ArsphenamineSalvarsanSpirochaetal infections (obsolete)
Chloramphenicol(Bs)ChloromycetinMeningitis, MRSA, topical use, or for low-cost internal treatment. Historic: typhus, cholera. Gram-negative, Gram-positive, anaerobesRarely: aplastic anemia.Inhibits bacterial protein synthesis by binding to the 50S subunit of the ribosome
FosfomycinMonurol, MonurilAcute cystitis in womenThis antibiotic is not recommended for children and 75 and up of ageInactivates enolpyruvyl transferase, thereby blocking cell wall synthesis
Fusidic acidFucidin
MetronidazoleFlagylInfections caused by anaerobic bacteria; also amoebiasis, trichomoniasis, giardiasisDiscolored urine, headache, metallic taste, nausea; alcohol is contraindicatedProduces 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.
MupirocinBactrobanOintment for impetigo, cream for infected cutsInhibits isoleucine t-RNA synthetase (IleRS) causing inhibition of protein synthesis
Platensimycin
Quinupristin/DalfopristinSynercid
ThiamphenicolGram-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)TigacylSlowly 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 patientsSimilar structure with tetracycline, but five times stronger, big volume distribution and long half-time in the body
TinidazoleTindamax FasigynProtozoal infectionsUpset stomach, bitter taste, and itchiness
Trimethoprim(Bs)Proloprim, TrimpexUrinary tract infections
Generic NameBrand NamesCommon 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 nameOriginSusceptible phylaStage of developmentMechanism of action
Unclassified
TeixobactinEleftheria terraeGram-positive, including antibiotic resistant S. aureus and M. tuberculosisNo human trials scheduledBinds fatty acid precursors to cell wall
MalacidinsUncultured BacteriumGram-positive, including antibiotic resistant S. aureusNo human trials scheduledBinds 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. 1 2 3 4 Aoki M (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. Zhanel GG, Lam A, Schweizer F, Thomson K, Walkty A, Rubinstein E, Gin AS, Hoban DJ, Noreddin AM, Karlowsky JA (2008). "Ceftobiprole: a review of a broad-spectrum and anti-MRSA cephalosporin". American Journal of Clinical Dermatology. 9 (4): 245–54. doi:10.2165/00128071-200809040-00004. PMID 18572975. S2CID 24357533.
  4. 1 2 3 4 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. Retrieved November 2, 2012.(subscription required)
  6. Berger DS (2014-04-03). GIDEON Guide to Antimicrobial Agents (2014 ed.). GIDEON Informatics Inc. p. 221. ISBN 978-1-61755-839-9. Retrieved 4 February 2015.
  7. Splete H, Kerri Wachter (March 2006). "Liver toxicity reported with Ketek". Internal Medicine News.
  8. McDonald LC, Gerding DN, Johnson S, Bakken JS, Carroll KC, Coffin SE, Dubberke ER, Garey KW, Gould CV, Kelly C, Loo V, Shaklee Sammons J, Sandora TJ, Wilcox MH (March 2018). "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. doi:10.1093/cid/cix1085. PMC 6018983. PMID 29462280.
  9. Tannock GW, Munro K, Taylor C, Lawley B, Young W, Byrne B, Emery J, Louie T (November 2010). "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. doi:10.1099/mic.0.042010-0. PMID 20724385.
  10. 1 2 Dificid (fidaxomicin) [prescribing information] Whitehouse Station, NJ: Merck; December 2015.
  11. Casellas JM, Israele V, Marín M, Ishida MT, Heguilen R, Soutric J, Arenoso H, Sibbald A, Stamboulian D (September 2005). "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. doi:10.1016/j.ijporl.2005.03.016. PMID 16061111.
  12. "APO-Amoxycillin and Clavulanic Acid 500mg/125 mg Tablets" (PDF). Retrieved November 27, 2014.
  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". Retrieved February 7, 2014.
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