A Textbook of Clinical Pharmacology and Therapeutics

Table 43.2:

New antibacterial agents

Linezolid

Moxifloxacin

Telithromycin

Ertapenem

Antibiotic class

Oxazolidinone

Fluoroquinolone with an

Ketolide; a semisynthetic member

Carbapenem

8-methoxyquinolone structure

of the macrolide-lincosamide-streptogramin B family of antibiotics

Mechanism

Inhibits formation of

Inhibits topoisomerase II and

Inhibits bacterial protein synthesis by

Attaches to penicillin-binding

of action

the 70S ribosomal initiation

IV with bactericidal activity

direct binding to the 50S subunit of

proteins, inhibiting bacterial

complex, preventing

bacterial ribosomes, preventing

cell wall synthesis; bactericidal

bacterial protein

translation and ribosome assembly

activity

synthesis; primarily bacteriostatic action

Spectrum of

Gram-positive bacteria

Gram-positives, including staphylococci,

Gram-positives, including

Streptococcus

Most enteric bacteria, including

activity

and a few Gram-negative

enterococci,

Streptococcus pneumoniae

,

pneumoniae

(including erythromycin

those producing beta-lactamase;

anaerobic bacteria; active

including penicillin-resistant strains;

resistant strains),

Streptococcus pyogenes

,

Gram-negative respiratory

against staphylococci,

atypicals, including

Legionella

and

MRSA; some Gram-negative bacteria,

pathogens, including

Moraxella

pneumocococci and

Mycoplasma pneumoniae

; Gram-negatives,

including

Haemophilus influenzae

,

catarrhalis

and

Haemophilus

enterococci, including

including

Haemophilus influenzae

,

Moraxella catarrhalis

; atypicals, including

influenzae

; Gram-positive

those resistant to

Moraxella catarrhalis

, coliforms,

Mycoplasma pneumoniae

,Chlamydia

bacteria, including

Streptococcus

penicillin and vancomycin

Neisseria gonorrhoeae

; low activity against

pneumoniae

and

Legionella

; not active

pneumoniae

(including those

Pseudomonas

and some enterobacteriaceae;

against erythromycin resistant strains

resistant to penicillin) and MRSA;

active against

Mycobacterium tuberculosis

,

of MRSA

also effective against many

including multiresistant strains; inhibits

anaerobes, including

Bacteroides

,

90% of anaerobic bacteria including

Prevotella

and

Porphyromonas

;

clostridia,

Bacteroides

,Fusobacterium

,

limited activity against

Porphyromonas

Pseudomonas aeruginosaAcinetobacter

;Enterococcus

,

Lactobacillus

, MRSA

From Lever A. Recently introduced antibiotics: a guide for the general physician.

Clinical Medicine

2004;

4 : 494–8.