
1. Inhibit Cell wall synthesis
1.1. Beta-Lactams
1.1.1. Penicillins (-cillin)
1.1.1.1. 1st Generation (Natural Penicillins)
1.1.1.1.1. Penicillin G (Benzyl penicillin)
1.1.1.2. Semisynthetic penicillins
1.1.1.2.1. Acid-resistant
1.1.1.2.2. Penicillinase-resistant (cover Staph)
1.1.1.2.3. Extended spectrum
1.1.1.3. Beta-lactamase inhibitors (-bactam)
1.1.1.3.1. (amoxicillin+) **Clavulonic acid**
1.1.1.3.2. (piperacillin+) **Tazobactam**
1.1.1.3.3. (ampicillin+) **Sulbactam**
1.1.1.3.4. (ceftazidime+) **Avibactam**
1.1.2. Cephalosporin (Cef-)
1.1.2.1. **1st Generation** - alternative to penicillin/cloxacillin - prophylactic for clean & clean/con surgery - not cover animal bites - cover Strep, Staph (MSSA)
1.1.2.1.1. Oral
1.1.2.1.2. Parenteral
1.1.2.1.3. Lab
1.1.2.2. **2nd Generation** - grame+ve น้อยลง - gram-ve มากขึ้น
1.1.2.2.1. Oral
1.1.2.2.2. Parenteral
1.1.2.3. **3rd Generation** - cover Penicillin-resistant pneumococi - active against H.influ
1.1.2.3.1. Oral - not cover Pseudomonas - lower uniray excretion
1.1.2.3.2. Parenteral
1.1.2.4. **4rd Generation** - cover grame+ve&grame-ve - Enterobacter, Citrobacter - Cerratia - Pseudomonas - Strep, Staph - **80% of AmpC beta-lactamase is resistant** to this and need to use alternative Carbapenems or Aminyglycosides (MIC≥ 4µg)
1.1.2.4.1. Parenteral
1.1.2.5. **5th Generation**
1.1.2.5.1. **Ceftaroline**
1.1.2.5.2. **Certobiprole**
1.1.2.5.3. **Cefiderocol**
1.1.3. Carbapenems (-penem)
1.1.3.1. Group 1 "narrow spectrum"
1.1.3.1.1. **Ertapenem**
1.1.3.2. Group 2 "broad spectrum" - cover Pseudomonas - A.baum resistant 100%
1.1.3.2.1. **Imipenem/Cilastatin**
1.1.3.2.2. **Meropenem**
1.1.3.2.3. **Doripenem**
1.1.3.2.4. **Biapenem**
1.1.4. Monobactams (-onam) - cover gram-ve
1.1.4.1. **Aztreonam**
1.1.4.1.1. - narrow spectrum - GNB e.g. Pseudomonas ยังไม่มีในไทย
1.2. Glycopeptides - cover gram+ve
1.2.1. **Vancomycin**
1.2.2. Teicoplanin
1.3. Other
1.3.1. Cycloserine
1.3.2. Bacitracin
2. Cause leakage from cell membrane (disrupt cell membrane integrity)
2.1. Polymyxins
2.1.1. Polymyxin B
2.1.2. Colistin (Polycymxin E)
2.1.2.1. cover A.baum
2.2. Polypeptide
2.2.1. **Bacitracin**
2.3. Polyene
2.3.1. **Amphotericin B **
2.3.1.1. cover fungal and leishmaniasis
3. Inhibit protein synthesis
3.1. 30S Ribosome Target
3.1.1. Tetracyclines
3.1.1.1. Tigecycline
3.1.1.2. Doxycycline
3.1.1.3. Minocycline
3.1.2. Aminoglycosides - cover gram-ve
3.1.2.1. from Streptomyces (-mycin)
3.1.2.1.1. **Streptomycin**
3.1.2.1.2. **Kanamycin**
3.1.2.1.3. Tobramycin
3.1.2.2. from Micromonospora (-micin)
3.1.2.2.1. **Gentamicin**
3.1.2.2.2. Amikacin
3.2. 50S Ribosome Target
3.2.1. Macrolides (-thromycin) - cover gram+ve - effective for respiratory inf.
3.2.1.1. Erythromycin
3.2.1.2. Clarithromycin
3.2.1.3. Azithromycin
3.2.2. Lincosamides (-linmycin)
3.2.2.1. Lincosamycin
3.2.2.2. **Clindamycin**
3.2.3. Oxazolidinones (-zolid)
3.2.3.1. Linezolid
3.2.3.2. Tedizolid
4. Inhibit DNA Gyrase (bacterial topoisomerase II + IV)
4.1. Quinolones
4.1.1. Nonfluorinated quinolone
4.1.1.1. Nalidixic acid
4.1.2. Fluoroquinolones (-floxacin)
4.1.2.1. 1st Generation
4.1.2.1.1. **Norfloxacin**
4.1.2.1.2. **Ciprofloxacin**
4.1.2.1.3. **Ofloxacin**
4.1.2.1.4. Pefloxacin
4.1.2.2. 2nd Generation
4.1.2.2.1. Respiratory quinolones
4.1.2.2.2. Gemifloxacin
4.1.2.2.3. Prulifloxacin
4.1.2.2.4. Lomefloxacin
4.1.2.2.5. Sparfloxacin
5. Interfere with DNA function
5.1. Inhibit bacterial DNA-dependent RNA polymerase
5.1.1. Rifamycins (Rifa-)
5.1.1.1. Rifampin (Rifampicin)
5.1.1.1.1. often use for TB and meningococcal
5.1.1.2. Rifabutin
5.2. **Metronidazole**
5.2.1. cover anaerobes and protozoa
5.3. Nitrofurantoin
6. Inhibit folic synthesis
6.1. Inhibit dihydropteroate synthase
6.1.1. Sulfonamides (Sulfa-)
6.1.1.1. Short acting
6.1.1.1.1. **Sulfadiazine**
6.1.1.2. Intermediate acting
6.1.1.2.1. **Sulfamethoxazole** (+trimethoprim)
6.1.1.3. Long acting
6.1.1.3.1. Sulfamethopyrazine
6.1.1.4. Special purpose
6.1.1.4.1. Sulfacetamide
6.1.1.4.2. **Sulfasalazine**
6.1.1.4.3. **Silver sulfadiazine**
6.1.1.4.4. Mafenide
6.1.2. Sulfones
6.1.2.1. **Dapsone**
6.2. Inhibits bacterial dihydrofolate reductase
6.2.1. Trimethoprim
6.2.2. Pyrimethamine