Antimicrobial Agents - Inhibition of DNA and Protein Synthesis
Bacterial chromosome replication
DNA replication
Bacterial Topoisomerases
maintain DNA in appropriate state of supercoiling
cut and reseal DNA
DNA gyrase (topoisomerase II) introduces negative supercoils
Topoisomerase IV decatenates circular chromosomes
these are the targets of the quinolone antibacterial agents
Quinolones
bind to bacterial DNA gyrase and topoisomerase IV after DNA strand breakage
prevent resealing of DNA
disrupt DNA replication and repair
bactericidal (kill bacteria)
Fluoroquinolone is particularly useful against
Gram +ves: Staphylococcus aureus, streptococci
Gram -ves: Enterobacteriacea; Pseudomonas aeruginosa
Anaerobes: e.g. Bacteroides fragilis
many applications e.g. UTIs, prostatitis, gastroenteritis, STIs
Adverse effects
Relatively well tolerated
GI upset in ~ 5% of patients
allergic reactions (rash, photosensitivity) in 1 - 2% of patients
Inhibition of Bacterial Protein Synthesis
Macrolides
in 1952: Erythromycin was isolated as the first macrolide (Streptomyces erythreus)
Newer macrolides: clarithromycin, azithromycin
Structurally they consist of a lactone ring (14- to 16-membered) + two attached deoxy sugars
Mode of action
bind reversibly to bacterial 50S ribosomal subunit
causes growing peptide chain to dissociate from ribosome → inhibiting protein synthesis
bacteriostatic (stops reproduction)
Macrolides’ spectrum of activity
good antistaphylococcal and antistreptococcal activity
treatment of respiratory & soft tissue infections and sensitive intracellular pathogens • e.g. Chlamydia, Legionella
Adverse effects
Generally well tolerated
nausea
vomiting
diarrhoea
rash
Aminoglycosides
large family of antibiotics produced by various species of Streptomyces ("mycin") and Micromonospora ("micin")
include: streptomycin, neomycin, kanamycin, gentamicins, tobramycin
Structure = linked ring system composed of aminosugars and an aminosubstituted cyclic polyalcohol
Mode of action of aminoglycosides
Bind irreversibly to 30S ribosomal subunit
disrupt elongation of nascent peptide chain
translational inaccuracy → defective proteins
bactericidal
Spectrum of activity
broad spectrum; mainly aerobic G-ve bacilli (e.g. P. aeruginosa)
used to treat serious nosocomial infections (hospital acquired infections)
First TB antibiotic
Used for cystic fibrosis
Adverse effects
all aminoglycosides have low Therapeutic Index (only a small amount needed to become toxic)
renal damage, ototoxicity, loss of balance, nausea












