ANTIBIOTICS TYPES (other topics)
Penicillins are bactericidal, inhibiting formation of the cell wall. There are four types of penicillins: the narrow-spectrum penicillin-G types, ampicillin and its relatives, the penicillinase-resistants, and the extended spectrum penicillins that are active against pseudomonas. Penicillin-G types are effective against gram-positive strains of streptococci, staphylococci, and some gram-negative bacteria such as meningococcus. Penicillin-G is used to treat such diseases as syphilis, gonorrhea, meningitis, anthrax, and yaws. The related penicillin V has a similar range of action but is less effective. Ampicillin and amoxicillin have a range of effectiveness similar to that of penicillin-G, with a slightly broader spectrum, including some gram-negative bacteria. The penicillinase-resistants are penicillins that combat bacteria that have developed resistance to penicillin-G. The antipseudomonal penicillins are used against infections caused by gram-negative Pseudomonas bacteria, a particular problem in hospitals. They may be administered as a prophylactic in patients with compromised immune systems, who are at risk from gram-negative infections.
Side effects of the penicillins, while relatively rare, can include immediate and delayed allergic reactions—specifically, skin rashes, fever, and anaphylactic shock, which can be fatal.
Like the penicillins, cephalosporins have a Β-lactam ring structure that interferes with synthesis of the bacterial cell wall and so are bactericidal. Cephalosporins are more effective than penicillin against gram-negative bacilli and equally effective against gram-positive cocci. Cephalosporins may be used to treat strains of meningitis and as a prophylactic for orthopedic, abdominal, and pelvic surgery. Rare hypersensitive reactions from the cephalosporins include skin rash and, less frequently, anaphylactic shock.
Streptomycin is the oldest of the aminoglycosides. The aminoglycosides inhibit bacterial protein synthesis in many gram-negative and some gram-positive organisms. They are sometimes used in combination with penicillin. The members of this group tend to be more toxic than other antibiotics. Rare adverse effects associated with prolonged use of aminoglycosides include damage to the vestibular region of the ear, hearing loss, and kidney damage.
Tetracyclines are bacteriostatic, inhibiting bacterial protein synthesis. They are broad-spectrum antibiotics effective against strains of streptococci, gram-negative bacilli, rickettsia (the bacteria that causes typhoid fever), and spirochetes (the bacteria that causes syphilis). They are also used to treat urinary-tract infections and bronchitis. Because of their wide range of effectiveness, tetracyclines can sometimes upset the balance of resident bacteria that are normally held in check by the body's immune system, leading to secondary infections in the gastrointestinal tract and vagina, for example. Tetracycline use is now limited because of the increase of resistant bacterial strains.
The macrolides are bacteriostatic, binding with bacterial ribosomes to inhibit protein synthesis. Erythromycin, one of the macrolides, is effective against gram-positive cocci and is often used as a substitute for penicillin against streptococcal and pneumococcal infections. Other uses for macrolides include diphtheria and bacteremia. Side effects may include nausea, vomiting, and diarrhea; infrequently, there may be temporary auditory impairment.
The sulfonamides are synthetic bacteriostatic, broad-spectrum antibiotics, effective against most gram-positive and many gram-negative bacteria. However, because many gram-negative bacteria have developed resistance to the sulfonamides, these antibiotics are now used only in very specific situations, including treatment of urinary-tract infection, against meningococcal strains, and as a prophylactic for rheumatic fever. Side effects may include disruption of the gastrointestinal tract and hypersensitivity.
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