Antibiotics specific drugs

Figure 12-7. Proposed sites of inhibition (0) of the respiratory chain by specific drugs, chemicals, and antibiotics. The sites that appear to support phosphorylation are indicated. BAL, dimercaprol. TTFA, an Fe-chelating agent. Complex I, NADHiubiquinone oxidoreductase complex II, succinate ubiquinone oxidoreductase complex III, ubiquinohferricytochrome c oxidoreductase complex IV, ferrocytochrome ctoxygen oxidoreductase. Other abbreviations as in Figure 12-4.

Danse tte PM, Delaforge M, Sartori E, Beaune P, Jaouen M, Mansuy D. Drug interactions with macrolide antibiotics Specificity of pseudo-suicide inhibition and induction of cytochrome P-450. Adv Exp Med Biol 1986 197 155-62. 

The prevention of aminoglycoside-induced nephrotoxicity has received considerable attention in recent years. Alternative antibiotics should be used whenever possible and as soon as microbial sensitivities are known. Commonly used alternatives include fluoroquinolones (e.g., ciprofloxacin or levofloxacin) and third-generation cephalosporins (e.g., ceftazidime). When aminoglycosides are necessary, the specific drug used does not appear to significantly affect the risk of nephrotoxicity, and therapy should be selected to optimize antimicrobial efficacy. Furthermore, it is imperative to avoid volume depletion, limit the total aminoglycoside dose administered, and avoid concomitant therapy with other nephrotoxic drugs. 

The years between 1940 and 1959 have been justly called the golden era of antibiotic discovery. During this period every important class of antibacterial antibiotic now known was recognized (Table III). Indeed, many specific drugs (e.g., benzylpenicillin, streptomycin, oxytetracycline, chloramphenicol, neomycin, and erythromycin) which presently occupy major places in therapeutic practice were discovered during that period. 

Pneumonia can result from infection by bacteria, viruses or fungi. Bacterial pneumonia is treated with antibiotics viral pneumonia may not need specific drug treatment, but in serious cases antiviral drugs can be used. Fungal pneumonia usually only occurs in immunocompromized patients and must be treated with oral antifungal drugs. 

Inhibitors of initiation-complex formation and rRNA-ribosome interactions represent important groups of therapeutic antibiotics, specifically the tetracyclines and aminoglycosides. The third area of protein synthesis that is significantly affected by drugs is peptide bond formation and translocation. Here, chemically diverse antibiotics such as chloramphenicol, lincomycin, and erythromycin are found. 

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