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Narrow-spectrum antibiotics have low propensity to induce bacterial resistance and are less likely to disrupt the microbiome (normal microflora). [3] On the other hand, indiscriminate use of broad-spectrum antibiotics may not only induce the development of bacterial resistance and promote the emergency of multidrug-resistant organisms, but also cause off-target effects due to dysbiosis.
Antibiotics with less reliable but occasional (depending on isolate and subspecies) activity: occasionally penicillins including penicillin, ampicillin and ampicillin-sulbactam, amoxicillin and amoxicillin-clavulnate, and piperacillin-tazobactam (not all vancomycin-resistant Enterococcus isolates are resistant to penicillin and ampicillin)
Piperacillin is a broad-spectrum β-lactam antibiotic of the ureidopenicillin class. [1] The chemical structure of piperacillin and other ureidopenicillins incorporates a polar side chain that enhances penetration into Gram-negative bacteria and reduces susceptibility to cleavage by Gram-negative beta lactamase enzymes.
[14] [15] In contrast to many conventional antibiotics these peptides appear to be bactericidal [2] instead of bacteriostatic. In general the antimicrobial activity of these peptides is determined by measuring the minimal inhibitory concentration (MIC), which is the lowest concentration of drug that inhibits bacterial growth. [16]
Dicloxacillin is a narrow-spectrum β-lactam antibiotic of the penicillin class. [1] It is used to treat infections caused by susceptible (non-resistant) Gram-positive bacteria . [ 1 ] It is active against beta-lactamase -producing organisms such as Staphylococcus aureus , which would otherwise be resistant to most penicillins .
Monobactam antibiotics exhibit no IgE cross-reactivity reactions with penicillin but have shown some cross reactivity with cephalosporins, most notably ceftazidime, which contains an identical side chain as aztreonam. [8] Monobactams can trigger seizures in patients with history of seizures, although the risk is lower than with penicillins.
Lincosamides are often used clinically as an alternative antibiotic for patients who are allergic to penicillin. Of the lincosamides, clindamycin is most commonly used within the clinic due to its higher bioavailability, higher oral absorption and efficacy within the target organism spectrum. [ 23 ]
Ranitidine, sucralfate, antacids containing magnesium or aluminium, supplements containing calcium, iron, or zinc: co-administration with these substances can lead to therapeutic failure of the antibiotic due to decreased absorption by the intestinal tract. For example, magnesium or aluminium antacids turn enoxacin into insoluble salts that are ...