Other Antibacterial Drugs

Several other antibacterial drugs work by mechanisms that are either unknown or are different from the classical antibacterial mechanisms described previously. These drugs are discussed individually here. 

Capreomycin (Capastat) is used as an adjunct or alternative drug for the treatment of tuberculosis. The drug s mechanism of action is unknown. The primary problems associated with this drug include ototoxicity and nephrotoxicity. 

Daptomycin (Cubicin) is unique in that this drug binds to the cell membrane of susceptible bacteria and depolarizes the cell. Loss of membrane polarity results in a general inhibition of cell function and subsequent death of the bacterium. This drug is used primarily to treat skin infections caused by certain staphylococcal, streptococcal, and enterococcal bacteria. Because of its unique mechanism of action, daptomycin may also be 

Isoniazid (INH, Laniazid, Nydrazid, other names) is one of the primary drugs used to treat tuberculosis.24,61 Although the exact mechanism of action is unknown, this drug appears to interfere with several enzymatic pathways involving protein, lipid, carbohydrate, and nucleic acid metabolism in susceptible bacteria. Adverse reactions to isoniazid are common, and patients may develop disorders such as hepatitis and peripheral neuropathies. 

Methenamine (Hiprex, Mandelamine, Urex) exerts antibacterial properties in a unique fashion. In an acidic environment, this drug decomposes into formaldehyde and ammonia. Formaldehyde is bactericidal to almost all bacteria, and bacteria do not develop resistance to this toxin. This mechanism enables methenamine to be especially useful in treating urinary tract infections, because the presence of this drug in acidic urine facilitates the release of formaldehyde at the site of infection (i.e., within the urinary tract). Use of methenamine is safe, although high doses are associated with gastrointestinal upset and problems with urination (bloody urine, pain while urinating). 

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Superinfection As with other antibacterial drugs, use of tigecycline may result in overgrowth of nonsusceptible organisms, including fungi. Carefully monitor patients during therapy. If superinfection occurs, take appropriate measures. 

Drug resistance To reduce the development of drug-resistant bacteria and maintain the efficacy of nitrofurantoin and other antibacterial drugs, only use nitrofurantoin to treat or prevent infections that are proven or strongly suspected to be caused by bacteria. 

Therapy for infection Ronan McMullan and Amit Bedi Introduction Antibacterial agents Other antibacterial drugs Antifungal drugs Antiviral therapy INTRODUCTION... 

In a retrospective study the data on fluoroquinolones and other antibacterial drugs, rufloxacin was associated with a reporting rate of 221 reports/daily defined dose/ 1000 inhabitants/day, and the most frequent were psychiatric disorders (278). 

Polymyxin B is not used systemically because of its neurotoxicity and nephrotoxicity. Topically, it is used in combination with other antibacterial drugs or steroids to prevent and treat skin infections and external otitis. 

Methicillin and oxacillin their use is now confined to laboratory sensitivity tests. Identification of methicillin-resistant Staphylococcus aureus (MRSA) in patients indicates the organisms are resistant to flucloxacillin and cloxacillin, all other P-lactam antibiotics and often to other antibacterial drugs, and demands special infection-control measures. 

Even in patients with normal renal function, adverse reactions have occurred in up to 25%, contributing to death in 5% (10). At therapeutically equivalent doses, suggestions of differences in nephrotoxicity or neurotoxicity between polymjTtin B and colistin are not convincing. In view of their potential for adverse effects, the poljmjodns have now been largely replaced by other antibacterial drugs. 

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