Complete list of antibiotics in India

Introduction of antibiotics 💊💉

A substance that inhibits the growth of microorganisms or kills them and causes no harm to the host cell called an antimicrobial agent or antibiotic drugs. The antimicrobial agent is of, natural, semi-synthetic, or synthetic origin. 

Alexander Fleming was a British investigator who discovered penicillin.  In 1928 Fleming describe the enzyme lysozyme. He observed that the Petri dish culture of staphylococci had become contaminated with green mold and that the bacteria were disappearing as the mold grew over the plate. The mold isolated was identified as Penicillium and found that the broth contained an active principle with antibacterial characters. 

Rene Dubos in 1939 indicated that soil bacteria could produce anti-bacterial chemicals like Fleming's penicillin. a group of Oxford University, led by British pathologist, Howard Florey and German biochemist, Ernst Boris Chain, reisolated penicillin and carried out careful trials with the highly purified samples. American pharmaceutical companies developed technology for the large-scale production of penicillin. 

Fleming, Florey, and Chain received Nobel Prize in 1945 for the development and discovery of penicillin. penicillin is the first antibiotic.

What is chemotherapy:

Without damaging the host cells, chemical compounds or drugs uses for the treatment of infectious diseases known as chemotherapy.

The main types of antimicrobial drugs

Antibiotics are chemical substances, produced by microorganisms, having the properties of inhibiting the growth or destroying the microorganism.

Antibacterial agents, It is synthesized in the laboratory.

Semisynthetic antibiotics. Many antimicrobial agents have a chemical structure is derived from the microbial source but its chemical structure is then modified by attaching different chemical moieties.

Explain the mode of action of antimicrobial drugs

Bacteriostatic	Bactericidal	Fungistatic	Fungicidal
Arrest the growth and replication of the bacteria thus break the spread of infection. or the drugs which prevent the growth of microorganisms called Bacteriostatic.	The bactericidal drug, kill, or irreversible damage the multiplying bacteria. or the drugs that destroy the microorganisms are called bactericidal drugs.	Arrest the growth and replication of the fungi thus break the spread of infection	The fungicidal drug, kill, or irreversible damage the multiplying fungi.

Mechanism of action of antibiotics drugs: Antibiotics drugs act as.

Inhibit bacterial cell wall synthesis, eg. →	Penicillins	Cephalosporins	Monobactams	Carbapenems
Alter of cell membrane integrity, eg.→	Polymixins	Amphotericin-B	Azoles	Chlorhexidine
Inhibit of ribosome protein synthesis, eg.→	Aminoglycosides	Tetracyclines	Macrolides	Clindamycin
Suppression of DNA synthesis, eg.→	Sulfonamides	Trimethoprim

Types of antimicrobial drugs Spectrum 💊

According to the spectrum of activity, antimicrobial drugs are grouped as,

1. Narrow spectrum drugs,
2. Broad-spectrum drugs,
3. Extended-spectrum drugs.

Narrow spectrum-  It is selectively effective either on gram+ve or gram - ve bacteria or certain fungi, yeast, or active against a limited group of pathogens are called narrow-spectrum antimicrobial drugs. such as benzylpenicillin, erythromycin, vancomycin.

Broad-spectrum - It is effective in numerous pathogens such as gram +ve bacteria, gram - ve bacteria, viruses, rickettsiae, or a wide range of pathogens, which are called broad-spectrum antimicrobial drugs. Like tetracycline, chloramphenicol, streptomycin, amoxicillin.

Extended-spectrum drugs - They are effective against gram-positive organisms and some gram-negative pathogens.

👉 Antibiotics are effective against gram-positive bacteria such as penicillin, ampicillin, etc.

👉 Antibiotics are effective against gram-negative bacteria such as streptomycin, gentamicin, etc.

👉 Antibiotics are effective against both gram +ve and gram-negative bacteria, etc.

Penicillins:

Discovered → Alexander Fleming 1929.

Origin → mold Penicillium notatum and Penicillium chrysogenum.

MOA → bactericidal.

Adverse effects → Anaphylactic shock, idiosyncrasy, allergy reaction.

Uses → Upper respiratory infection, Urinary tract infection, rheumatic fever

Classification	Penicillin drugs
Natural penicillin	Penicillin- G (Benzyl Penicillin)
	Piperacillin
Broad-spectrum penicillin	Ampicillin, Amoxycillin, Ampicillin with Sulbactam Sodium
Penicillinase resistant penicillin	Cloxacillin
Penicillin active against pseudomonas	Carbenicillin.

Aminoglycosides antibiotics

Aminoglycosides are derived from the species of Streptomycin. Gentamicin is the first drug to be given for infections by gram-negative bacteria. Neomycin is now used as topical antibiotics for eye bacterial conjunctivitis or gram-negative infection.

Uses of aminoglycosides antibiotics drug:

 It is very effective against gram-negative bacteria. 

• Bacteraemias,
• Septicaemias,
• Respiratory tract infection,
• Bone and joint infection,
• CNS,
• Skin and soft tissue infection,
• intraabdominal infection,
• Burns,
• Postoperative infection.

Aminoglycosides	Drugs
Amikacin,	Tobramycin sulfate
Neomycin,	sisomicin,
Tobramycin	Streptomycin
Netilmicin,
Kanamycin
Gentamicin,

Carbacephems antibiotics

Loracarbef.

Carbapenem:

Carbapenem is a synthetic Beta-Lactum antibiotic. It is given by injection (by parenteral route) into the body. for uses of,

• Pneumonia,
• Intra-abdominal infection,
• Gynecological infection,
• Skin infection.
• Meningitis,
• Septicemia
• Febrile neutropenia.

Carbapenem	Drugs
Meropenem Trihydrate	Faropenem,
Imipenem with Cilastatin
Ertapenem,
Doripenem
Panipenem.
Biapenem,

Cephalosporins antibiotics

Discover → In 1960.

Isolated → fungus, Cephalosporinium acremonium (Cephalosporins), and Streptomyces lactamdurans (cefamycin).

Cephalosporium. Now many semi-synthetic drugs are developed from it. 

cephalosporins are an alternative to penicillin. 

Uses:

• Staphylococcal boils or wounds, 
• Streptococci,
• Bacterial pneumonia,
• Urinary tract infections by gram-negative bacteria.

Classification	Cefalosporin drugs
1st generation cefalosporin	Cefalexin, Cefadroxil,Cefradine,  Cefazolin,
2nd generation cefalosporin	Cefaclor, Cefuroxime. Cefprozil. Cefotetan, Cefamandole, Cefoxitin
3rd generation cefalosporin	Cefixime, Cefpodoxime, Ceftibuten,   Cefdinir, Cefditoren, Ceftolozane, Cefoperazone, Ceftriaxone,  Cefotaxime, Ceftazidime, Ceftizoxime.
4th generation cefalosporin	Cefepime, Cefpirome, Cefozopran
5th generation cefalosporin	Ceftaroline, Ceftobiorole.

Combination with other medicine

Cephalosporins w/β- lactamase inhibitors:

• Ceftazidime + Avibactam,
• Ceftolozane + Tazobatam,
• Cefoperazone + Sulbatam,
• Cefoperazone + Tazobactam,
• Ceftrixone + Sulbactam,
• cefotaxime + sulbactam,
• Cefuroxime + Clavulanic acid,
• Cefixime  + Clavulanic acid,
• Ceftazidime + Tazobactam,
• Ceftrixone + Tazobactam.

Chloramphenicol antibiotics

Chloramphenicol is the first broad-spectrum antibiotic. It was isolated in 1947 by Ehrlich, Burkholder, and Gotlieb. It inhibits a wide variety of Gram-positive and gram-negative bacteria. And rickettsiae and fungi. it inhibits protein synthesis at the 50S ribosomal level. it is a bacteriostatic drug.

Uses:

1. Typhoid fever,
2. Meningitis,
3. Urinary tract infection,
4. ENT infection,
5. intracranial bacteria infection.

• Chloramphenicol.

Ketolides antibiotics 

Ketolides approved for the first time in 2004. telithromycin is used for the treatment of bronchitis, sinusitis, and pharyngitis.

• Telithromycin

Lincosamides antibiotics

it is used in treating a serious infection like a liver abscess, lung bases, bone, and joint infection.

• Lincomycin,
• Clindamycin.

Oxazolidinones antibiotics

It is an antibiotic medicine, used when there is a bacterial infection in the body. This antibiotic medicine is given in the case of the following disease,

Uses of Oxazolidinones

• Pneumonia infection,
• Skin infection,
• febrile neutropenia septicemia,
• Endocarditis,
• Osteomyelitis surgical prophylaxis.

Oxazolidinones drugs:

1. Linezolid,
2. Tedizolid,
3. Radezolide,
4. Torezolide.

Macrolides antibiotics

macrolides drugs are a Bacteriostatic and broad spectrum of activity. it is used against gram-negative bacteria and gram-positive bacteria. macrolides inhibit the protein synthesis of the bacteria.  it is used.

Uses of Macrolides drugs:

• Upper respiratory tract infection,
• Acute  pneumonia,
• Vaginitis infection,
• wound and burn infection,
• Infected eczema,
• Acne vulgaris,
• Skin infection.

macrolides	drugs
Azithromycin,	Clarithromycin,
Roxithromycin,	Polymyxin B
Aztreonam	Telithromycin
Teicoplanin	Vancomycin
Colistimethate	Erythromycin,
Spiramycin.	Colistin
Lincomycin	Clindamycin
Spectinomycin

Glycylcyclines antibiotics

Tigecycline is the new glycylcycline antibiotic, approved by the FDA in June 2005. It is broad-spectrum antibiotics. it is effective against gram-positive, gram-negative, and multidrug-resistant pathogens. it is effective for the treatment of complicated skin infection and intra-abdominal infection.

• Tigecycline

Macrocyclic antibiotics:

• Fidaxomicin.

Glycopeptides:

MOA → Bacterial cell wall synthesis drug. bacteriocidal.

glycopeptides drugs

• Dalbavancin
• Oritavancin,
• Teicoplanin
• Telavancin,
• Vancomycin.

Monobactams:

• Aztreonam.
• Nitrofurantoin:
• Nitrofurantoin.

Oxacephalosporins:

• Flomoxef,
• Latamoxef.

Sulphonamides Antimicrobial drug

Structure →  analogs of p-aminobenzoic acid (PABA.

MOA → bacteriostatic.

it is a synthetic antimicrobial agent. 

Uses of Sulphonamides antimicrobial drug: sulfonamide mainly used these days with a combination.

• Urinary tract infection,
• Respiratory tract infection,
• Sexually tract infection,
• skin infection.

Classification	Sulphonamides drugs
Short-acting Sulfonamide drugs	Sulfisoxazole, Sulfamethizole
Intermediate-acting sulfonamide drug	Sulfamethoxazole, Sulfamoxole
Longe acting Sulfonamide drugs	Sulfadoxine, Sulphamethixypyridazine
Topical drugs	Silver Sulfadiazine, Mafenide, Sulfacetamide

Synergistic combination:

• Trimethoprim + sulfamethoxazole (Cotrimoxazole),
• Sulfadoxine + Pyrimethamine.

Cyclic Lipopeptides:

• Daptomycin.

Diaminopyrimidines:

• Trimethoprim.

Quinolones:

They are effective against Gram-negative aerobes, gram-positive cocci.  this group of antibacterial drugs has broader antimicrobial activity. 

uses of quinolones: 

• urinary tract infection, 
• bacterial diarrhea, 
• Salmonella typhi infection, 
• sexually transmitted infection, 
• soft tissue, and wound infection, 
• respiratory tract infection, 

Classification	Quinolones drugs
1st generation drugs.	Ciprofloxacin, Ofloxacin, Pefloxacin, Lomefloxacin, Nalidixic acid
2nd Generation	Levofloxacin,  Prulifloxacin
3rd generation.	Sparfloxacin, Gatifloxacin
4th generation	Moxifloxacin, Trovafloxacin, Finafloxacin.

Tetracycline antibiotics

Tetracycline is a broad-spectrum bacteriostatic antibiotic drug. it has a 4 cyclic anthracycline ring structure. it is used for the treatment of,

• fever,
• Typhus fever,
• Pneumonia,
• respiratory tract infection,
• genitourinary infection,
• dental infection,
• ENT infection,
• Gynecological infection.

Doxycyclin

Tetracycline

Minocycline

Tigecycline

Source:

• Principles of pharmacology: h. L Sharma and K. K Sharma. paras medical publisher.
• Drug today India,
• CIMS India,
• Pharma ecology Diploma in pharmacy,