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antibiotics that inhibit protein synthesis


									                  USE                                         MODE OF ACTION                                ADVERSE EFFECTS                    RESISTANCE
OXAZOLIDINONES    Multi drug resistant G+                     Blockage of translation initiation            Well tolerated                     Rare
(LINEZOLID)                                                   Binds the 23S on the 50S ribosomal            Diarrhea, headache, nausea,        Due to mutation in 23S rRNA
                                                              subunit                                       and vomiting                       No cross-resistance
                                                              Inhibits binding of formyl methionine-tRNA
                                                              to A site
STREPTOGRANINS    Multi drug resistant G+                     Inhibit bacterial protein synthesis           Diarrhea                           MLSb- conformational changes in the
(QUINUPRISTIN-                                                Bind to peptidyl transferase of the 50S       AAPMC                              peptidyl transferase
DALFOPRISTIN)                                                 ribosomal subunit                             Inhibit cytochrome p450            Enzymatic inactivation
                                                                                                                                               Increased efflux

CHLORAMPHENICOL   Anaerobic bacteria                          Binds the 50S subunit close to macrolide      Aplastic anemia                    Enzyme inactivation
                                                              and clindamycin                               Dose related                       Plasmid encoded enzyme
                                                              Inhibits binding of aminoacyl-tRNA and        thrombocytopenia,                  choramphenicol acetyl transferase
                                                              blocks elongation step of protein synthesis   reticulocytopenia, leukopenia      Less common- decreased
                                                              Binds to mammalian mito. Ribosomes            Grey Syndrome                      permeability & altered ribosomes
                                                                                                            Irrerversible binds cyto p450
MACROLIDES        E: alternative to penicillin; diphtheria,   Binds to the 50S ribosomal subunit            Very safe                          Reduced permeability or increased
(ERYTHROMYCIN,    cornyebacteria, strep, staph, syphilis,     preventing translocation; close to binding    Inhibits cyto p450                 efflux
AZITHROMYCIN,     mycoplasma, chlamydia                       site for lincomycin, chloramphenical,                                            MLSb
CLARITHOMYCIN)    C: like E including, mycobacteria           strepgramin B                                                                    Enterobacteriaceae- inactivation by
                  leprae, toxoplasmosis gondi                                                                                                  esterases
                  A: legionella, sexually transmitted                                                                                          Complete cross resistance
                  agents, chlamydia, neisseria
                  gonorrhea, streptococcal
LINCOSIDES        Anaerobes- Bacteroides fragilis             Binds to the large 50S ribosomal subunir      AAPMC                              MLSb
(CLINDAMYCIN)                                                                                                                                  Alterations in the 50S due to mutation
                                                                                                                                               in 23S
TETRACYCLINE      Pelvic and urinary chlamydia                Inhibit elongations step by binding to the    Tooth discoloration                Plasmid mediated
                  Rickettsia                                  30S ribosomal subunit                         Ab associated colitis              Decrease/increase efflux
                  Mycoplasma                                  Blocks binding of amino-acyl tRNA             Hepatotoxicity, Renal Toxicitiy,   Rarely due to changes in the
                  V. Cholerea                                                                               GI irritation, diarrhea            ribosome
                  Spirochetes                                                                               H2 antagonists inhibit             Cross resistance
                                                                                                            absorption, increase effects of
                                                                                                            anticoagulants and digoxin.
                                                                                                            Decrease effectiveness of oral
AMINOGLYCOSIDES   Aerobic G- bacteria                         Blockade of translation initiation            Ototoxicity and nephrotoxicity     Enzymatic inactivation
(STREPTOMYCIN,                                                Misincorp. Of amino acids into the
GENTAMICIN,                                                   nascent poly. Chain
TOBRAMYCIN,                                                   Disassembly of poly monoribosomes

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