Antimicrobial Agents -Â Inhibition of DNA and Protein Synthesis
Bacterial chromosome replication
DNA replication
Bacterial TopoisomerasesÂ
maintain DNA in appropriate state of supercoilingÂ
cut and reseal DNA
DNA gyrase (topoisomerase II) introduces negative supercoilsÂ
Topoisomerase IV decatenates circular chromosomesÂ
these are the targets of the quinolone antibacterial agentsÂ
Quinolones
bind to bacterial DNA gyrase and topoisomerase IV after DNA strand breakageÂ
prevent resealing of DNAÂ
disrupt DNA replication and repairÂ
bactericidal (kill bacteria)
Fluoroquinolone is particularly useful against
Gram +ves: Staphylococcus aureus, streptococciÂ
Gram -ves: Enterobacteriacea; Pseudomonas aeruginosaÂ
Anaerobes: e.g. Bacteroides fragilisÂ
many applications e.g. UTIs, prostatitis, gastroenteritis, STIsÂ
Adverse effects
Relatively well tolerated
GI upset in ~ 5% of patientsÂ
allergic reactions (rash, photosensitivity) in 1 - 2% of patientsÂ
Inhibition of Bacterial Protein SynthesisÂ
MacrolidesÂ
in 1952: Erythromycin was isolated as the first macrolide (Streptomyces erythreus)Â
Newer macrolides: clarithromycin, azithromycinÂ
Structurally they consist of a lactone ring (14- to 16-membered) + two attached deoxy sugarsÂ
Mode of actionÂ
bind reversibly to bacterial 50S ribosomal subunitÂ
causes growing peptide chain to dissociate from ribosome → inhibiting protein synthesisÂ
bacteriostatic (stops reproduction)
Macrolides’ spectrum of activity
good antistaphylococcal and antistreptococcal activityÂ
treatment of respiratory & soft tissue infections and sensitive intracellular pathogens • e.g. Chlamydia, LegionellaÂ
Adverse effects
Generally well tolerated
nauseaÂ
vomitingÂ
diarrhoeaÂ
rashÂ
Aminoglycosides
large family of antibiotics produced by various species of Streptomyces ("mycin") and Micromonospora ("micin")Â
include: streptomycin, neomycin, kanamycin, gentamicins, tobramycinÂ
Structure = linked ring system composed of aminosugars and an aminosubstituted cyclic polyalcoholÂ
Mode of action of aminoglycosides
Bind irreversibly to 30S ribosomal subunitÂ
disrupt elongation of nascent peptide chainÂ
translational inaccuracy → defective proteinsÂ
bactericidalÂ
Spectrum of activityÂ
broad spectrum; mainly aerobic G-ve bacilli (e.g. P. aeruginosa)Â
used to treat serious nosocomial infections (hospital acquired infections)
First TB antibiotic
Used for cystic fibrosisÂ
Adverse effects
all aminoglycosides have low Therapeutic Index (only a small amount needed to become toxic)
renal damage, ototoxicity, loss of balance, nauseaÂ

















