ABSTRACT
Introduction .................................................................................................................................... 132 Antibacterial Agents ...................................................................................................................... 132
Inhibition of Cell Wall Synthesis ........................................................................................ 132 Drugs that Inhibit Cell Wall Biosynthetic Enzymes................................................ 132 Drugs that Bind to Carrier Molecules...................................................................... 133 Drugs that Combine with Cell Wall Precursors ...................................................... 133 Drugs that Inhibit Enzymatic Polymerization and Attachment of New
Peptidoglycan to Cell Wall (β-Lactams) .................................................... 134 Interference with Cytoplasmic Membrane Integrity .......................................................... 136
Drugs that Disorganize the Cytoplasmic Membrane .............................................. 136 Drugs that Produce Pores in Membranes ................................................................ 136
Inhibition of Nucleic Acid Synthesis .................................................................................. 137 Inhibitors of DNA Replication ................................................................................. 137 Inhibitors of RNA Polymerase: Rifamycins (Rifampin and Rifaximin) ................. 137
Inhibition of Ribosome Function and Protein Synthesis .................................................... 138 Inhibitors of 30S Ribosomal Subunits ..................................................................... 138 Inhibitors of 50S Ribosomal Subunits ..................................................................... 138
Inhibition of Synthesis of Essential Small Molecules ........................................................ 140 Inhibitors of Dihydropteroate Synthetase ................................................................ 140 Inhibitors of Dihydrofolate Reductase ..................................................................... 140
Antimycobacterial Agents ............................................................................................................. 140 Inhibition of Cell Wall Synthesis ........................................................................................ 140
Isoniazid (Isonicotinic Acid Hydrazide, INH) ........................................................ 140 Cycloserine .............................................................................................................. 140 Ethambutol ............................................................................................................... 141
Interference with Cytoplasmic Membrane Function: Pyrazinamide ................................. 141 Inhibition of Nucleic Acid Synthesis .................................................................................. 141
Rifamycins: Rifampin, Rifabutin, and Rifapentine ................................................. 141 Fluoroquinolones as Antimycobacterial Agents ...................................................... 141
Inhibition of Protein Synthesis ........................................................................................... 141 Aminoglycosides: Streptomycin and Amikacin ...................................................... 141
Antifungal Agents .......................................................................................................................... 141 Inhibition of Cell Wall Synthesis ........................................................................................ 141
Echinocandins: Caspofungin, Micafungin, and Anidulafungin ............................. 141 Interference with Membrane Integrity ............................................................................... 142
Polyenes: Amphotericin B and Nystatin .................................................................. 142 Azole Antifungal Drugs .......................................................................................... 142 Allylamines: Terbinane ......................................................................................... 143
Since the previous edition of this Handbook, many new antibiotics have been developed and are now on the market or undergoing clinical trials. There are many compounds with antimicrobial activity. This chapter, however, attempts to summarize current information about, and working models for, the mechanisms of action only of antimicrobial agents that are in clinical use or in advanced stages of investigation, or that illustrate important points or are used in laboratory research. This chapter also provides references to more extensive information.
