[Antimicrobial mechanisms of action].
A large number of families and groups of antimicrobial agents are of clinical interest. The mechanisms by which compounds with antibacterial activity inhibit growth or cause bacterial death are varied and depend on the affected targets. The bacterial cell wall-a unique structure in most bacteria that is absent in eukaryotic cells-can be affected in several ways: at different stages of synthesis (fosfomycin, cycloserine) or transport (bacitracin, mureidomycins) of its metabolic precursors, or by a direct action on its structural organization (beta-lactams, glycopeptides). The main drugs affecting the cytoplasmic membrane are polymyxins and daptomycin. Protein synthesis can be blocked by a large variety of compounds that affect any of the phases of this process, including activation (mupirocin), initiation (oxazolidinones, aminoglycosides), binding of the tRNA amino acid complex to ribosomes (tetracyclines, glycylcyclines) and elongation (amphenicols, lincosamides, macrolides, ketolides, streptogramins, fusidic acid). The metabolism of nucleic acids can be altered at the DNA-dependent RNA polymerase or in the process of DNA coiling (quinolones); some compounds affect DNA directly (nitroimidazoles, nitrofurans). Trimethoprim and sulfamides (often used in combination) are examples of antimicrobial agents that block bacterial metabolic pathways. Some compounds are unable to inhibit or kill bacteria in themselves, but can block bacterial mechanisms of resistance, enhancing the activity of other antimicrobials administered in combination. Among this group of agents, only certain beta-lactamase inhibitors are currently in clinical use.
Calvo
Jorge
J
Servicio de Microbiología, Hospital Universitario Marqués de Valdecilla, Santander, España.
Martínez-Martínez
Luis
L
D000900:Anti-Bacterial Agents / Q000145:classification / Q000494:pharmacology*; D001419:Bacteria / Q000187:drug effects; D001426:Bacterial Proteins / Q000096:biosynthesis / Q000235:genetics; D002462:Cell Membrane / Q000187:drug effects; D002473:Cell Wall / Q000187:drug effects / Q000378:metabolism; D004249:DNA Damage; D004269:DNA, Bacterial / Q000187:drug effects; D024881:Drug Resistance, Bacterial / Q000187:drug effects; D005493:Folic Acid Antagonists / Q000494:pharmacology; D015964:Gene Expression Regulation, Bacterial / Q000187:drug effects; D006801:Humans; D065093:beta-Lactamase Inhibitors
D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D004269:DNA, Bacterial; D005493:Folic Acid Antagonists; D065093:beta-Lactamase Inhibitors