Chemicals used to treat disease: antibacterials, antifungals, antivirals.
Plants, bacteria, fungi (and many are ancient remedies).
Alexander Fleming; he called it “mould juice” before “penicillin.” Howard Florey, Ernst Chain, Norman Heatley, Mary Hunt (Mary Hunt found a strong-producing strain).
Drug kills/inhibits pathogen while harming host as little as possible.
Drug level needed for clinical treatment.
Drug level where it becomes too toxic (side effects).
Toxic dose / therapeutic dose; want it as large as possible.
Undesirable effects of a drug on host cells.
Inhibition doesn’t always mean killing; you must measure—you can’t predict. Pathogen can often grow again (because MIC is inhibitory, not necessarily lethal).
Dilution susceptibility test . MIC = lowest concentration with no visible growth in broth/agar.
broth dilution test. Subculture “no growth” tubes into drug-free medium; the lowest concentration where microbe can’t be recovered = MLC.
Antibiotic diffuses and inhibits growth; bigger zone = more susceptible (for that setup). Antibiotic is not effective against that bacterium.
If the same antibiotic inhibits both a Gram+ (e.g., S. aureus) and Gram− (e.g., E. coli) it suggests broad spectrum.
Cell wall synthesis, protein synthesis, metabolic antagonists, nucleic acid synthesis.
Reach infection site, pathogen susceptibility, body levels exceed MIC, dose amount, route (topical/oral/IV), uptake speed, clearance rate, toxicity.
Mainly Gram+ (narrow); block transpeptidation (cross-linking) → incomplete wall → lysis; act best on actively growing cells making new PG.
This class is “not great” because resistance can develop readily.
Structurally/functionally similar; broad-spectrum; early generations mainly Gram+, later modified to include more Gram−.
Gram+ have lots of PG; Gram− have an outer membrane barrier that reduces drug entry.
Glycopeptides; bind D-Ala–D-Ala motif in PG; too large to pass Gram− outer membrane.
Used for antibiotic-resistant MRSA and enterococcal infections.
Cyclohexane ring + amino sugars; active vs Gram− aerobic & facultative anaerobes; bind 30S → inhibit protein synthesis + cause mRNA misreading.
Broad-spectrum, bacteriostatic; bind 30S; block aminoacyl-tRNA binding to the A site.
Sometimes used to treat acne.
: Bind 23S rRNA of 50S; inhibit peptide chain elongation; often used for patients allergic to penicillin.
Needed for DNA synthesis and as a cofactor in many reactions (Vitamin B9).
PABA analogs; competitively inhibit enzymes in folic acid synthesis → selective toxicity.
Bacteriostatic.
Also blocks folic acid production; combining with sulfa blocks two steps → higher efficacy + harder resistance.
Side effects include abdominal pain and photosensitivity; used for UTIs.
Inhibit DNA gyrase and topoisomerase II; bactericidal; excellent tissue penetration (good for internal infections).
Very effective vs Gram+ (e.g., S. aureus) but can be toxic; inserts near phosphatidylglycerol, aggregates → forms holes/depolarizes membrane; “new class” because new mode of action.
Difficult to synthesize in lab—easier to isolate from environment.
Pumps (often ABC transporters) export antibiotics → lowers intracellular concentration; often non-specific.
Alter entry routes—mutate transporters or reduce transporter presence.
Chemically modify or degrade the antibiotic (can act inside or outside cell).
Change the structure of the molecule the drug binds to → drug binds poorly.
Use a different enzyme that performs the same function but isn’t inhibited.
If growth stops, some antibiotics (like wall synthesis inhibitors) have little effect; spores/growth shutdown are less susceptible.
Microbial warfare, horizontal gene transfer, evolutionary pressure from widespread antibiotic use.
On plasmids → easy transfer between bacteria.
They apply selection pressure without fully eliminating bacteria → enrich resistant cells.
~10⁻⁶ to 10⁻⁷
~4,600,000 bp. On average ~1 mutation per cell.
Infections can contain billions to trillions of cells → rare mutants are practically guaranteed.
It can be transmitted to other bacteria (even different species).
One mechanism (e.g., efflux) can impact multiple classes; mechanisms aren’t “confined.”
Cells may be slow-growing, so many antibiotics are less effective
If you stop early, symptoms may improve but survivors remain; resistant/persister cells get selected and the infection can rebound.
ask: (1) Does the drug need to enter the cell? (2) What’s the target?
If it must enter, then permeability changes + efflux + target change can all matter.
If it acts outside, permeability/efflux may matter less.
Change the structure of a protein (alter the target enzyme / binding). Per the notes: it doesn’t need to enter the cytoplasm.
decrease permeability, alter target protein, efflux pumps.
Flatten/plateau (cells stop increasing, but OD doesn’t “crash”).
