| Table 7.5 Drugs that inhibit bacterial cell wall synthesis | |||
|---|---|---|---|
|
[Drugs that i]nteract directly with penicillin-binding protein (PBPs) and inhibit transpeptidase activity |
|||
| Drug class | Specific drugs | Natural or semisynthetic | Spectrum of activity |
| Penicillins | Penicillin G, penicillin V | Natural | Narrow-spectrum against gram-positive and a few gram-negative bacteria |
| Ampicillin, amoxicillin | Semisynthetic | Narrow-spectrum against gram-positive bacteria but with increased gram-negative spectrum | |
| Methicillin | Semisynthetic | Narrow-spectrum against gram-positive bacteria only, including strains producing penicillinase | |
| Cephalosporins | Cephalosporin C | Natural | Narrow-spectrum similar to penicillin but with increased gram-negative spectrum |
| First-generation cephalosporins | Semisynthetic | Narrow-spectrum similar to cephalosporin C | |
| Second-generation cephalosporins | Semisynthetic | Narrow-spectrum but with increased gram-negative spectrum compared with first generation | |
| Third- and fourth-generation cephalosporins | Semisynthetic | Broad-spectrum against gram-positive and gram-negative bacteria, including some β-lactamase producers | |
| Fifth-generation cephalosporins | Semisynthetic | Broad-spectrum against gram-positive and gram-negative bacteria, including MRSA | |
| Monobactams | Aztreonam | Semisynthetic | Narrow-spectrum against gram-negative bacteria, including some β-lactamase producers |
| Carbapenems | Imipenem, meropenem, doripenem | Semisynthetic | Broadest spectrum of the β-lactams against gram-positive and gram-negative bacteria, including many β-lactamase producers |
|
Large molecules that bind to the peptide chain of peptidoglycan subunits, blocking transglycosylation and transpeptidation |
|||
| Drug class | Specific drugs | Natural or semisynthetic | Spectrum of activity |
| Glycopeptides | Vancomycin | Natural | Narrow spectrum against gram-positive bacteria only, including multidrug-resistant strains |
|
Block transport peptidoglycan subunits across cytoplasmic membrane |
|||
| Drug class | Specific drugs | Natural or semisynthetic | Spectrum of activity |
| Bacitracin | Bacitracin | Natural | Broad-spectrum against gram-positive and gram-negative bacteria |