Classification of antibiotics According to mechanism of action
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Classification of antibiotics according to mechanism of action
| Mechanism | Main antibiotic classes | Examples |
|---|---|---|
| 1. Inhibitors of cell-wall synthesis | Beta-lactams, glycopeptides, bacitracin, fosfomycin, cycloserine | Penicillins, cephalosporins, carbapenems, aztreonam, vancomycin, teicoplanin |
| 2. Disruptors of cell-membrane function | Polymyxins, lipopeptides | Polymyxin B, colistin, daptomycin |
| 3. Inhibitors of protein synthesis | 30S inhibitors: aminoglycosides, tetracyclines. 50S inhibitors: macrolides, lincosamides, chloramphenicol, oxazolidinones, streptogramins | Gentamicin, amikacin, doxycycline, azithromycin, clindamycin, linezolid |
| 4. Inhibitors of nucleic-acid synthesis or function | Fluoroquinolones, rifamycins, nitroimidazoles, nitrofurantoin | Ciprofloxacin, levofloxacin, rifampicin, metronidazole |
| 5. Antimetabolites: inhibitors of folate synthesis | Sulfonamides, diaminopyrimidines | Sulfamethoxazole, sulfadiazine, trimethoprim, co-trimoxazole |
| 6. Antimycobacterial agents with specific targets | Mycolic-acid inhibitors, arabinogalactan inhibitors, ATP synthase inhibitors | Isoniazid, ethambutol, pyrazinamide, bedaquiline |
Key targets
- Cell wall: prevents peptidoglycan synthesis, leading to cell lysis.
- Cell membrane: damages membrane integrity, causing leakage of cellular contents.
- Protein synthesis: binds bacterial ribosomes.
- 30S: aminoglycosides, tetracyclines
- 50S: macrolides, clindamycin, chloramphenicol, linezolid
- Nucleic acids: inhibits DNA replication, RNA transcription, or damages DNA.
- Folate metabolism: blocks tetrahydrofolate production needed for bacterial nucleotide synthesis.
Bactericidal versus bacteriostatic
- Usually bactericidal: beta-lactams, glycopeptides, aminoglycosides, fluoroquinolones, metronidazole, polymyxins, daptomycin, rifampicin.
- Usually bacteriostatic: tetracyclines, macrolides, lincosamides, chloramphenicol, sulfonamides, trimethoprim, linezolid.
Some classifications vary with organism, concentration, and clinical setting.
This five-group classification is consistent with Rockwood and Green's Fractures in Adults, Table 29A, p. 3453. The text categorizes antibiotics as cell-wall, cell-membrane, protein-synthesis, nucleic-acid, and metabolic-process inhibitors.
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