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Antibiotics by Mind Map: Antibiotics

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