How Do Other Antibiotics Work?

Reviewed on 1/19/2022

How do other antibiotics work?

Antibiotics are medications administered to treat bacterial infections. Other antibiotics are medications that are not categorized into any specific classes of antibiotics. Other antibiotics include several types of drugs that work in unique ways to prevent bacterial growth (bacteriostatic) or cause death (bactericidal) of multiple bacteria species.

Other antibiotics include the following:

  • Bacitracin: Bacitracin is primarily used to treat ophthalmic and skin infections. Bacitracin prevents bacterial growth by inhibiting bacterial cell wall synthesis. Currently, bacitracin intramuscular injections are discontinued in the US and may only be given to children for Staphylococci lung infections if less toxic antibiotics are ineffective. 
  • Chloramphenicol: Chloramphenicol is used only for acute and serious infections that cannot be treated with less toxic alternative antibiotics. Chloramphenicol binds to the bacterial ribosomes (cellular particles that synthesize proteins) and prevents protein synthesis that is necessary for bacterial growth.
  • Colistin: Colistin is used to treat bacterial infections from susceptible strains of certain gram-negative bacteria such as Pseudomonas aeruginosa. Gram-negative bacteria are structurally different from gram-positive bacteria, identified by whether they get dyed or not in the Gram stain lab test. Colistin damages the bacterial cell membrane and kills it.
  • Fosfomycin: Fosfomycin is used to treat urinary tract infections. Fosfomycin is a phosphoric acid derivative that prevents bacterial adhesion to the urinary tract, prevents bacterial wall synthesis, and kills the bacteria. Fosfomycin works by inactivating pyruvyl transferase, an enzyme essential for bacterial wall synthesis.
  • Iclaprim: Iclaprim is an antibiotic in clinical trials to treat acute bacterial skin and skin structure infections and hospital-acquired bacterial pneumonia. Iclaprim prevents the synthesis of folic acid required for bacterial growth by inhibiting dihydrofolate reductase, an important enzyme in the process of folate synthesis.
  • Linezolid: Linezolid is a new class of antibiotic known as oxazolidinone used to treat skin and soft tissue infections and pneumonia caused by gram-positive bacteria that are resistant to other antibiotics including methicillin and vancomycin. Linezolid binds to the bacterial ribosomes and blocks protein synthesis that enables bacterial growth.
  • Methenamine: Methenamine is an antiseptic and antibacterial drug used to prevent and suppress recurrent urinary tract infections, in which prolonged antibiotic use can lead to resistance. Methenamine breaks down in acidic urine into ammonia and formaldehyde which are bactericidal. The salt component of the drug contains hippuric or mandelic acid which acidifies the urine.
  • Methenamine/hyoscyamine/methylene blue/phenyl salicylate/sodium phosphate monobasic: This combination drug is used to treat irritative voiding symptoms from urinary tract infection or diagnostic procedures. In acidic urine, methenamine releases ammonia and formaldehyde that kill bacteria and sodium acid phosphate maintain urine acidity. Hyoscyamine relaxes the bladder’s smooth muscles, methylene blue is an antiseptic, and phenyl salicylate is a mild analgesic.
  • Methenamine/sodium acid phosphate: Methenamine/sodium acid phosphate combination is used to prevent and suppress recurrent urinary tract infections. Sodium acid phosphate acidifies the urine and methenamine releases ammonia and formaldehyde which kill bacteria by denaturing the bacterial proteins and nucleic acid.
  • Methenamine/sodium salicylate/benzoic acid: In this methenamine combination, methenamine is bactericidal, benzoic acid maintains the required level of urine acidity for methenamine to release ammonia and formaldehyde and sodium salicylate has analgesic properties.
  • Metronidazole vaginal: Vaginal metronidazole is an antibacterial agent used to treat bacterial vaginosis. Vaginal metronidazole kills bacteria by disrupting bacterial DNA synthesis and is effective against many types of vaginal bacteria such as Gardnerella vaginalis, Mobiluncus species, and Peptostreptococcus species.
  • Nitrofurantoin: Nitrofurantoin is used for treating uncomplicated urinary tract infections and is effective against many gram-positive and gram-negative organisms. Nitrofurantoin kills bacteria by interfering with vital bacterial cellular processes such as the synthesis of DNA, RNA, cell wall proteins, and other metabolic enzymes.
  • Polymyxin B: Polymyxin B is used for treating serious and systemic infections when potentially less toxic alternative antibiotics cannot be used or are ineffective. Polymyxin B is a bactericidal drug that binds to fatty molecules on the cell membranes of gram-negative bacteria and causes leakage of cell contents leading to its death.
  • Rifamycin: Rifamycin is used to treat traveler’s diarrhea, caused by bacterial infections of the colon from ingesting contaminated food or water. Rifamycin prevents bacterial growth by inhibiting the bacterial DNA-dependent RNA polymerase, an enzyme that enables the transcription of DNA into RNA, thus blocking one of the steps in DNA synthesis.
  • Rifaximin: Rifaximin is a derivative of rifamycin and works similarly to stop bacterial growth. In addition to traveler’s diarrhea, rifaximin is used to inhibit bacterial growth in irritable bowel syndrome with diarrhea (IBS-D) and hepatic encephalopathy (HE), a nervous system disorder caused by liver disease. Rifaximin stops the growth of ammonia-producing enteric bacteria, reducing ammonia levels and lowering the risk of HE.
  • Sulfanilamide: Sulfanilamide is used in the form of vaginal cream to treat vaginal yeast (fungus) infections. Sulfanilamide stops bacterial growth by inhibiting para-aminobenzoic acid, a nutrient in the vitamin B complex, and interfering with microbial folic acid synthesis, both of which are essential for yeast to grow and multiply.
  • Trimethoprim: Trimethoprim is used to treat middle ear and urinary tract infections due to susceptible strains of gram-positive and gram-negative bacteria. Trimethoprim prevents the synthesis of folic acid essential for bacterial growth and survival by inhibiting dihydrofolate reductase, an important enzyme in the process of folate synthesis.

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What are the uses of other antibiotics?

Other antibiotics may be administered through various routes including:

  • Oral:
    • Tablets
    • Capsules
    • Powder dissolved in water
    • Solutions, suspensions
  • Injections:
    • Intramuscular (IM) injections into the muscle
    • Intravenous (IV) injections into the vein
    • Intrathecal injections into the spinal canal
  • Vaginal: Gels and creams applied inside the vagina

The FDA-approved uses of other antibiotics include:

  • Bacitracin:
    • Pneumonia or empyema (lung infections) in children, caused by susceptible strains Staphylococci, only if less toxic antibiotics are not effective (currently discontinued)
  • Chloramphenicol:
    • Serious infections in adults caused by susceptible bacterial strains
    • Systemic infections in children and newborns
  • Colistin:
    • Acute or chronic infections due to susceptible strains of certain gram-negative bacteria such as Pseudomonas aeruginosa, Enterobacter aerogenes, Escherichia coli and Klebsiella pneumoniae
  • Fosfomycin:
  • Iclaprim:
    • Acute bacterial skin and skin structure infections (pending FDA approval)
  • Linezolid:
    • Vancomycin-resistant enterococcal infections
    • Skin and skin structure infections (complicated and uncomplicated)
    • Community-acquired pneumonia (including concurrent bacteremia)
    • Nosocomial pneumonia (hospital-acquired pneumonia)
    • Methicillin-resistant staphylococcal infections (MRSA)
    • Methicillin-susceptible Staphylococcus aureus infection
  • Methenamine:
    • Prophylactic and suppressive treatment for recurrent urinary tract infections (UTIs) that require long-term therapy
  • Methenamine/hyoscyamine/methylene blue/phenyl salicylate/sodium phosphate monobasic:
    • Urinary tract irritative voiding symptoms resulting from urinary tract infections or diagnostic procedures
    • Methenamine/sodium acid phosphate:
    • Prophylactic and suppressive treatment for recurrent urinary tract infections that require long-term therapy
  • Methenamine/sodium salicylate/benzoic acid:
    • Prophylactic and suppressive treatment for recurrent urinary tract infections that require long-term therapy
  • Metronidazole vaginal:
    • Treatment of bacterial vaginosis
  • Nitrofurantoin:
    • Treatment of urinary tract infections caused by susceptible strains of Escherichia coli, Enterobacter species, Klebsiella species, Staphylococcus aureus, and S. saprophyticus
  • Polymyxin B:
    • Treatment of acute infections caused by susceptible strains of Pseudomonas aeruginosa
    • Treatment of serious and systemic infections caused by Haemophilus influenzae (meningitis), Escherichia coli (UTI), Enterobacter aerogenes and Klebsiella pneumoniae (bacteremia)
  • Rifamycin:
    • Traveler’s diarrhea caused by noninvasive strains of E. coli in adults, uncomplicated by fever or blood in stool
  • Rifaximin:
    • Traveler’s diarrhea caused by noninvasive strains of E. coli in patients 12 years of age and above, uncomplicated by fever or blood in stool
    • Reduction in risk of hepatic encephalopathy recurrence in adults
    • Irritable bowel syndrome with diarrhea (IBS-D) in adults
  • Sulfanilamide:
  • Trimethoprim:
    • Treatment of acute otitis media (middle ear infection) due to susceptible strains of Streptococcus pneumoniae or Haemophilus influenzae
    • Treatment of urinary tract infections caused by susceptible strains of Escherichia coli, Proteus mirabilis, Klebsiella pneumoniae, Enterobacter species, coagulase-negative Staphylococcus species including S. saprophyticus

What are side effects of other antibiotics?

Side effects of other antibiotics vary with each type of drug. A few of the most common side effects may include:

Information contained herein is not intended to cover all possible side effects, precautions, warnings, drug interactions, allergic reactions, or adverse effects. Check with your doctor or pharmacist to make sure these drugs do not cause any harm when you take them along with other medicines. Never stop taking your medication and never change your dose or frequency without consulting your doctor.

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What are names of some of the other antibiotics?

Generic and brand names of some of the other antibiotics include:

  • Aemcolo
  • AVC
  • BACiiM (discontinued)
  • bacitracin
  • chloramphenicol
  • Chloramphenicol IV
  • Chloromycetin
  • colistimethate sodium
  • colistin
  • Coly Mycin M
  • Cystex
  • Darpaz
  • fosfomycin
  • Furadantin
  • Hiprex
  • iclaprim (pending FDA approval)
  • linezolid
  • Macrobid
  • Macrodantin
  • methenamine
  • methenamine/hyoscyamine
  • methenamine/hyoscyamine/methylene blue/phenyl salicylate/sodium phosphate monobasic
  • methenamine/sodium acid phosphate
  • methenamine/sodium salicylate/benzoic acid
  • MetroGel Vaginal
  • metronidazole vaginal
  • Monurol
  • nitrofurantoin
  • Nuvessa
  • polymyxin B
  • Primsol
  • Proloprim
  • Prosed DS
  • relebactam
  • rifamycin
  • rifamycin SV MMX
  • rifaximin
  • sulfanilamide
  • TMP
  • trimethoprim
  • Uretron D/S
  • Urex
  • Uribel
  • Urogesic Blue
  • Uroquid-Acid No. 2
  • Utac
  • Uticap
  • Utrona-C
  • Vandazole
  • Xifaxan
  • Zyvox
References
https://reference.medscape.com/drugs/antibiotics-other

https://www.accessdata.fda.gov/drugsatfda_docs/label/2008/050717s005lbl.pdf

https://academic.oup.com/ofid/article/5/2/ofy003/4791932

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6759703/

https://www.ncbi.nlm.nih.gov/books/NBK470526/

https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/060716s018lbl.pdf

https://www.pdr.net/drug-summary/Primsol-trimethoprim-hydrochloride-832#14

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