Medical Microbiology

ThePrinciplesofAntibioticTherapy 189

Table3. 4 FrequentlyUsedAnti-InfectiveAgents

Class/activesubstance Remarks

Aminoglycoside/aminocyclitol

antibiotics

(dihydro)streptomycin Fortreatmentoftuberculosis

neomycin,paramomycin Onlyfororalortopicalapplication

kanamycin Parenteraladministration;resistancefrequent

gentamicin,tobramycin,

amikacin,netilmicin,

sisomicin

Neweraminoglycosides;broadspectrum;

noeffectonstreptococciandenterococci;

ototoxicityandnephrotoxicity;controlofserum

levelsduringtherapy

spectinomycin Againstpenicillinase-positivegonococci,in

urogenitalgonorrhea

Carbacephems Betalactamsstructuredlikecephalosporins,

butwithaCatominsteadofsulfurinthesecond

ringsystem(seefig.3. 29 ,p. 1 95)

loracarbef Oralcarbacephem;stableinthepresenceof

penicillinasesfromHaemophilusandMoraxella

4-Quinolones

norfloxacin,pefloxacin Oralquinolones;onlyinurinarytractinfections

ciprofloxacin,ofloxacin,

fleroxacin,enoxacin

Oralandsystemicquinoloneswithbroadspectrum

ofindications

levofloxacin,sparfloxacin Quinoloneswithenhancedactivityagainst

Gram-positiveand“atypical”pathogens

(chlamydias,mycoplasmas);caution—sparfloxacin

isphototoxic

gatifloxacin,moxifloxacin QuinoloneswithenhancedactivityagainstGram-

positiveand“atypical”pathogens(chlamydias,

mycoplasmas)andGram-negativeanaerobes

Cephalosporins

Group 1

cefazolin,cephalothin EffectiveagainstGram-positiveandsome

Gram-negativebacteria;stableinthepresenceof

staphylococcipenicillinases;unstableinthepres-

enceofbetalactamasesofGram-negativebacteria

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Kayser, Medical Microbiology © 2005 Thieme