Antibiotics that Block Protein Synthesis
Aminoglycosides: Gentamycin, Neomycin, Amikacin, Tobramycin, and, Streptomycin
–
Gram-negative infections
– Not effective against anaerobes
– Often used synergistically with
beta-lactams
– Bind the 30S subunit
Causes misreading of bacterial mRNA and blocking translocation
– Enzymatic inactivation of the antibiotics
– Nephrotoxicity
– Neuromuscular blockade
– Ototoxicity
– Contraindicated in pregnancy (teratogens)
Oxazolidinone: Linezolid
– Gram-positive bacteria
Staphylocci (including MRSA)
Enterococci (including VRE)
Streptococci
Clostridium
Some anaerobic cocci.
– Binds the 50S subunit
Inhibits the initiation complex and blocks protein synthesis.
– Myelosuppression (decreased bone marrow activity)
– Serotonin syndrome (particularly when given to patients who take antidepressants).
Lincosamide: Clindamycin
– Anaerobic bacteria
– Gram-positive cocci
Commonly used in
Streptococcus and
Staphylococcus infections
– Binds the 50S subunit
Blocks protein synthesis
– Diarrhea
–
Clostridium difficile colitis
– Rash
Macrolides: Azithromycin, Erythromycin, and Clarithromycin
Broad-spectrum
– Gram-positive bacteria
–
Neisseria
–
Legionella
–
Mycoplasma
–
Chlamydiae
–
Treponema
– Clarithromycin and Azithromycin are effective against some
Mycobacteria.
– Binds the 50S subunit
Block translocation and protein synthesis
– Gastrointestinal upset due to increased motility
–
QT prolongation
– Hepatotoxicity
Tetracyclines: Tetracycline, Doxycycline, and Minocycline
– Acne
– Doxycycline is effective against
MRSA infection
–
Borrelia burgdorferi
–
Mycoplasm pneumoniae
–
Rickettsia
–
Chlamydiae
Tetracyclines accumulate intracellularly, which accounts for their ability to act on intracellular bacteria.
– Bind the 30S subunit
Prevents aminoactyl-tRNA attachment and, therefore, block an early step in protein synthesis.
– Gastrointestinal discomfort
– Photosensitivity
– In
children these drugs can cause
tooth discoloration and bone growth inhibition
–
Contraindicated in pregnancy
–
Do not take with milk, antacids, or iron, which can interfere with their absorption in the gastrointestinal tract.