Bacteriostatic & Bactericidal Antibacterials Bactericidal drugs kill microbial cells, whereas bacteriostatic drugs prevent the growth of microbial cells. High doses of bacteriostatic drugs may act as bactericidal agents. MIC (Minimum Inhibitory Concentration) is the minimum conc. of bacteriostatic drug needed to inhibit bacterial growth. MBC (Minimum Bactericidal Concentration) is the minimumconc. of bactericidal drug needed to kill the microorganism. Ete UC ch Sulfonamides Macrolides Ethambutol Linezolid Tetracyclines Lincosamides Fusidic Acid Trimethoprim Nitroimidazoles Aminoglycosides Isoniazid Cephalosporins Quinolones Rifampicin GlycopeptidesSulfonamides Sulfonamides is a term encompassing many groups of drugs, each of which is based on the sulfa- functional group. Antibacterial sulfonamides act as competitive inhibitors of the enzyme dihydroopteroate synthetase (DHPS); an enzyme involved in folate synthesis. Sulfonamides are therefore bacteriostatic — inhibiting growth and multiplication — but do not cause cell death. Resistance today is common. Clinically Approved Sulfonamides Sulfacetamide Sulfadiazine Silver Sulfadiazine Sulfasalazine Sulfamethoxazole Mafenide Acne/Seborrheic Dermatitis Burns IBS/Rheumatoid Arthritis Urinary Tract Infections General Points Adverse Effects Sulfamethoxazole is often used as part of a 5:1 ratio with trimethoprim. | Nausea, Vomiting, Diarthoea Skin Rash/Allergy Neutropenia Sunlight Sensitivity Sulfasalazine can cause hemolytic anemia in those with GOPD Crystals in Urine deficiency. Evidence regarding use of silver sulfadiazine in the effective treatment of burns is poor.Quinolones ‘Quinoionesare broad-spectrumantibacterial drugs. The first quinolone — nalidixic acid — was discoveredin1962. by George Lesher and subsequently used in the treatment of urinary tract infections. uinolones workty selectively inhibiting topoisomerase thereby disrupting cel division. Later generation drags suchas gemifloxacinand monifioxacin-—have enkancedactivity at topaisomerase. {linia Approved Quinolones Nalidiic Acid Ciprofloxacin _Norfloxacin GeneratPoints [Naliisi acid isprimarily active against gram-negative, and was historically "used for urinary tactinfections -acondition that norfloxacin treats today. Ciprofloxacin should not be taken with magnestum, aluminium, calcum, fon ‘or zinc products. The drugls also contraindicated for use with themuscle telaranttizanidine, Levofloracin exhibits greater activity against gram-posttives than gram- negatives exhibits enhanced activity against Streptococcus pneumonia Gemifloradn and moxifloxacin are effective inthe treatment of bacterial ‘exacerbations of chronic bronchitispneumont Gemifioxacin Moxifioxacin averse Effects “Tendonitis/tendon rupture, particuartyin ‘those with myasthenia gravis ‘QT prolongation, particularly with ‘moxlfioracin| Clostridium difficile associated diarrhoea (NS effects: dizziness, headache, tremor, ‘ik of seizures ‘Nausea, vomiting, abdominal pain