CELL WALL INHIBITORS
MOA: INHIBITS CELL WALL SYNTHESIS ( LYSIS : breakdown of cell due to damage in
the cell wall) ( SELECTIVE TOXICITY)
● The Narrow spectrum provides a higher steric hindrance, which makes it
bactericidal.
● Broad Spectrum oral penicillins permits the entry via porins or pores.
○ Have no steric shields
○ Are acid stable.
PENICILLINS
Notes:
Only Narrow
Spectrum
penicillins are
B-lactamase
resistant
NARROW SPECTRUM
(Penicillinase -
RESISTANT)
BROAD SPECTRUM
(Penicillinase -
SENSITIVE)
EXTENDED
SPECTRUM
(Penicillinase -
SENSITIVE)
Parenteral: Not acid
stable, Increased
STERIC hindrance
Oral
( Addition of
IONIZED or POLAR
group)
Parenteral
Methicillin
Ampicillin ( +
Probenecid = tx of
gonorrhea)
Carbenicillin ( is
usually combined
with Gentamicin)
Nafcillin
Amoxicillin
(p-hydroxy analog of
ampicillin)
Ticarcillin
Oral: Presence of
electronegative Atom
(isoxazolyl)
Bacampicillin
(prodrug of
ampicillin)
UREIDOPENICILLINS
Oxacillin
Mezlocillin
Cloxacillin
Piperacillin
Dicloxacillin
Azlocillin
B LACTAMASE INHIBITORS
CLASS 1
CLASS 2
Clavulanic Acid ( ORAL, but not limited to it)
- Prepared in combination with
penicillins
CARBAPENEMS
Sulbactam - preventing bacteria from
destroying ampicillin
Thienamycin
Tazobactam - SHV-1 and TEM groups
Imipenem ( used with Cilastatin) - urinary
tract and urogenital infections, meningitis,
endocarditis and sepsis due to susceptible
organisms
Meropenem - skin and abdominal
(stomach area) infections caused by
bacteria and meningitis
Biapenem - used in trials studying the
treatment of Bacterial Infections
Doripenem - serious infections of the
urinary tract, kidney, and abdomen that are
caused by bacteria ( NOT FDA APPROVED
FOR PNEUMONIA)
CEPHALOSPORINS
- Cefazolin
- Ceftriaxone
ORAL
PARENTERAL
Cefuroxime Axetil
Cephalothin
Cefpodoxime
Proxetil
Cephradine
Cefixime
CEPHAMYCINS
Cephalexin
Cefoxitin
Cefadroxil
Cefotetan
Cefaclor
Cefmetazole
Cefprozil
Loracarbef
MONOBACTAMS
Aztreonam
Tigemonam
B-LACTAM COMBINATIONS
1. AMOXICILLIN + CLAVULANIC ACID
2. TICARCILLIN + CLAVULANIC ACID
3. AMPICILLIN + SULBACTAM
4. CARBENICILLIN + SULBACTAM
5. PIPERACILLIN + TAZOBACTAM
