Of the thousands of naturally occurring antibiotics, only a few dozen are currently used in medicine. The others are substances – for humans – that are toxic, carcinogenic or have other adverse effects.
The following groups of antibiotics and chemotherapeutics are currently used in the prevention and treatment of bacterial infections:
| 1. b-lactamspenicillins | penicillins with inhibitor, cephalosporins/cefamycins, monobactams, tri-bactams carbapenems, penems |
| 2. Aminoglycosidicosystreptomycin | neomycin, kanamycin, entamycin, tobramycin, netylmycin, isepamycin, amikacin |
| 3. Tetracyclines | doxycycline, tetracycline, minocycline |
| 4. Macrolides/ketolides | |
| old: | Erythromycin, spiramycin, iosamycin |
| new: | erythromycin cyclic carbonate (Dawercin), roxithromycin, clarithromycin, azithromycin, dirithromycin |
| ketolides | trolithromycin |
| 5. Lincosamides | lincomycin, clindamycin |
| 6. Streptogramins | pristinamycin, quinupristin, dalfopristin |
| 7. Oxazolidinones | linezolid |
| 8. Glycopeptidylvancomycin | vancomycin, teicoplanin |
| 9. Chloramphenicoldetreomycin | detreomycin |
| 10. Polymixins | colistin |
| 11. Rifamycins | rifampicin |
| 12. Sulphonamides | cotrimoxazole |
| 13. Nitroimidazoles | Metronidazole, ornidazole |
| 14. Nitrofurans | Nitrofurantoin, furagin, nifuroxazide |
| 15. Quinolone | pipemidine acid, norfloxacin, pefloxacin, ciprofloxacin, ofloxacin, levofloxacin, sparfloxacin, moxifloxacin, gemifloxacin |
| 16. Fusidic acid | |
| 17. Antifungal drugs:: | |
| polyenes: | Nystatin, amphotericin B |
| azoles: | fluconazole, itraconazole, ketoconazole, econazole, voriconazole |
| antimetabolites: | 5-5-fluorocytosine |
| 18. Antiviral drugs | acyclovir, didanosine, famcyclovir, gancyclovir, indinavir, lamivudine, nalfinavir, ritonavir, saquinavir, stavudine, zalcitabine, zidovudine |
All these substances differ, among other things, in their degree of absorption and penetration into tissues, as well as in their mode, extent and mechanism of action. These mechanisms, in general terms, boil down to:
- blocking the synthesis of substances essential for bacterial function,
- interference with RNA replication,
- disruption of protein synthesis in bacteria,
- impairment of microbial cell wall function and structure,
- blocking the synthesis of nucleic acids in the DNA of bacterial cells.
There are many different medicinal products available on the medical market for antibiotic therapy, some of which contain the same active substance. An example is amoxicillin, which can be found in more than 120 medicines. However, each of these medicines differs in name, concentration of the active substance, dosage regimen and indication of use. They may also have a different formulation, contain different compounds and carriers and have a different duration of action or withdrawal period. Nevertheless, it is the active substance and its appropriate choice and dosage that determines the success of the treatment.
The list of medicinal products authorised for use and marketing in Poland is available in the Official List of Medicinal Products. Detailed information can be found on the website of the Office for Registration of Medicinal Products, Medical Devices and Biocidal Products.