Synonym(s)
ClassificationThis section has been translated automatically.
Overview of common antibiotics in internal medicine (varies according to Hof 2019)
beta-lactam antibiotics (antibiotics with inhibition of bacterial cell wall synthesis, all of which are characterized by a common structural feature - a beta-lactam ring)
Penicillin
Classical penicillins (effective against Gram-positive germs and Gram-negative cocci and even Pasteurella multocida; not effective against penicillinase-active staphylococci; Haemophilus species and all other Gram-negative rod bacteria)
- Penicillin G (Depot form = Benzathine-penicillin G)
- Penicillin V
- Phenoxymethylpenicillin (acid stable)
Penicillinase-resistant penicillins (agent of choice against staphylococci; not effective against hospital staphylococci (MRSA); contraindication: severe renal insufficiency
- Methicillin
- Oxacillin
- Flucloxacillin
Aminopenicillins (effective against some gram-positive bacteria and against some enterobacteria; not penicillinase resistant, allergenic)
- Ampicillin
- Amoxicillin
- Mecillinam
Acylureidopenicillins (effective especially against many enterobacterials and pseudomonads; good penetration through cell wall; not penicillinase-resistant)
Cephalosporins (all cephalosporins have a gap in enterococci!)
- 1st generation cephalosporins (good effect on staphylococci and streptococci, weak against Haemophilus, E. coli, Klebsiella; penicillinase-resistant, sensitive to cephalosporinases; cefazolin only i. v.)
- Cefaclor
- Cefalexin
- Cefadroxil
- Cefazolin and others
- 2nd generation cephalosporins (compared to 1st generation improved effect against gram-negative germs; stable against penicillinase and many cephalosporinases)
- 3rd generation cephalosporins (very broad spectrum of activity with good effect against Gram-negative bacteria, but weaker effect against Gram-positive germs compared to 1st and 2nd generation)
- Cephalosporins 3a. (very broad spectrum of activity with good effect against Gram-negative bacteria, but weaker effect against Gram-positive germs compared to 1st and 2nd generation; only i. v. administration)
- Cephalosporins 3b. Generation (remarkably good activity against P. aeruginosa; only i. v. administration)
- 4th generation cephalosporins (very broad spectrum of activity with good effect against Gram-negative bacteria, but in comparison to 1st and 2nd generation weaker effect against Gram-positive bacteria; better against P. aeruginosa)
- Cefepime
- Cefpirome
- Cephalosporins 5th generation (good effect against anaerobes)
Penems (often effective against germs that are resistant to cephalosporins; inactivation of imipenem by renal enzymes (application together with cilastatin, an enzyme inhibitor)
Monobactams (Enterobacterales, not effective against gram-positive bacteria)
Oxalactame (inhibitor of betalactamases; has very little antibacterial activity itself; combination with amoxicillin and other penicillin derivatives; susceptible to spontaneous hydrolysis (do not allow prepared solutions to stand for long)
Other antibiotics with disruption of bacterial cell wall synthesis and the cytoplasmic membrane
Glycopeptides (only gram-positive bacteria; ototoxicity, nephrotoxicity)
Lipopeptides (only gram-positive bacteria; bactericidal; good tissue penetration; is inhibited by surfactant)
- Daptomycin
- Fosfomycin (limited spectrum; good penetration ability)
- polypeptides
- Bacitracin (gram-positive bacteria; not suitable for systemic therapy)
- Polymyxin B (gram-negative rods; reserved for special situations; neuro- and nephrotoxicity; rapid development of resistance)
- Colistin (gram-negative rods; reserved for special situations; neuro- and nephrotoxicity; rapid development of resistance)
Ethambutol (tubercle bacteria, neurotoxic)
Antibiotics with inhibition of bacterial protein synthesis
- Streptomycin (tubercle bacteria; frequent resistances; neurotoxicity; nephrotoxicity; ototoxicity)
- Gentamicin (broad activity, many Gram-positive and Gram-negative bacteria; no effect against anaerobes, streptococci and enterococci (as single substance); Cave: contraindicated in 1st trimester pregnancy, newborns and severe renal failure)
- Tobramycin (broad activity, many Gram-positive and Gram-negative bacteria; no effect against anaerobes, streptococci and enterococci (as single substance); Cave: contraindicated in 1st trimester pregnancy, newborns and severe renal failure)
- Amikacin (broad activity, many Gram-positive and Gram-negative bacteria; no effect against anaerobes, streptococci and enterococci (as single substance); Cave: contraindicated in 1st trimester pregnancy, newborns and severe renal failure)
- Netilmicin (broad activity, many Gram-positive and Gram-negative bacteria; no effect against anaerobes, streptococci and enterococci (as single substance); Cave: contraindicated in 1st trimester pregnancy, newborns and severe renal failure)
- Neomycin (broad activity, many Gram-positive and Gram-negative aerobic bacteria; topical and oral application)
- Paromomycin (broad efficacy, many Gram-positive and Gram-negative aerobic bacteria; topical and oral application; is not absorbed after oral administration, orally to reduce intestinal flora, for eradication of Entamoeba histolyticum)
- Kanamycin (broad activity, many Gram-positive and Gram-negative aerobic bacteria; topical and oral application)
- Spectinomycin (penicillinase-positive gonococci; currently not commercially available)
- Framycetin (only available as a topical agent, ointment or powder)
Macrolides (also effective against intracellular bacteria; ineffective against enterobacteriales; erythromycin increases the motility of the upper intestinal sections; the newer derivatives no longer have these side effects)
Lincomycins (Gram-positive aerobes and anaerobes and Gram-negative anaerobes; increasing resistance; Cave: Good penetration into bone tissue. Pay attention to the possible development of pseudomembranous enterocolitis).
Tetracyclines
tetracyclines (occasional resistance; deposition in the milk teeth and bones; Cave: contraindicated in 1st trimester pregnancy, children and severe renal failure)
- Tetracycline
- Oxytetracycline
- Doxycycline
- Minocycline
- Glycylcycline
Rifamycins (gram-positive pathogens, mycobacteria; also effective against intracellular bacteria and in biofilm)
Oxazolidinones (without exception all Gram-positive bacteria; ADR: thrombocytopenia)
- Linezolid
- Tedizolide
Fusidic acid (gram-positive bacteria; rapid development of resistance)
Hydroquinoline (Escherichia coli, other causative agents of urinary tract infections; ineffective against Pseudomonas; also effective against Candida spp.; effective against germs in biofilm)
- Nitroxolin
Antibiotics with disturbance of folic acid synthesis and various other enzyme functions in the bacterial cell
sulfonamides (effective against streptococci, pneumococci, actinomycetes, nocardia; frequent resistances; Cave: contraindicated in pregnancy 1st trimester, newborns and severe renal failure; allergy)
- Sulfanilamide
- Sulfamethoxazole
- sulfadiazine and others
Diaminopyrimidines (very broad spectrum; not effective against anaerobes, rickettsia, chlamydia, mycoplasma; also effective against the fungus Pneumocystis
- diaminopyrimidine/sulfamethoxazole
- Trimethoprim
- Cotrimoxazole
paraaminosalicylic acid (tubercle bacteria)
- PAS
Nitrofurans (urinary tract infections; Cave: contraindicated in 1st trimester pregnancy, newborns and severe renal failure and in old age; neurotoxic, allergenic)
- Nitrofurantoin
- Nitrofurazone and others
Isonicotinamide (tubercle bacteria; neurotoxic)
- Isoniazid (INH)
Antibiotics with effect on bacterial DNA
Nitroimidazole (Strict action on anaerobes and various protozoa; Cave: contraindicated in pregnancy 1st trimester, alcohol consumption)
Quinolones
- Quinolones 1st generation (gram negative rods)
- Nalidixic acid
- norfloxacin
- Chinolone 2nd generation (systemic infections with Enterobacteriales. Very effective against meningococci also for prophylaxis; moderate effect against pseudomonads)
- Ciprofloxacin (systemic infections with Enterobacteriales. Very effective against meningococci also for prophylaxis; moderate effect against pseudomonads; ciprofloxacin is partly excreted via the intestine. Also high concentrations in secretions, e.g. ELF (epithelial lining fluid)
- Quinolones 3rd generation
- Levofloxacin (quite good effect against gram-positive cocci; also against chlamydia and mycoplasma; is mainly excreted renally; also high concentrations in secretions)
- Quinolone 4th generation (quite good effect against gram-positive cocci; also against chlamydia, mycoplasma and anaerobes, is excreted to a large extent via the intestine; acts against anaerobes of the intestinal flora; also high concentrations in secretions)
LiteratureThis section has been translated automatically.
- Hof H et al. (2019) In: Hof H, Schlüter D, Dörries R, Duale Reihe Medizinische Mikrobiologie. 7th, completely revised and extended edition. Stuttgart: Thieme p.305-307