Penicillins

History

  • Penicillins were originally isolated from Penicillium mold

Pharmacology

Mechanism of Action

  • β-Lactam Antibiotic (see β-Lactam Antibiotics, [[β-Lactam Antibiotics]]): inhibit the formation of peptidoglycan cross-links in the bacterial cell wall
    • Four-membered β-lactam ring of penicillin binds to the DD-transpeptidase enzyme

Classes of Penicillins

Natural Penicillins

  • Benzathine Penicillin
  • Penicillin G (Benzylpenicillin) (see Penicillin G, [[Penicillin G]])
  • Penicillin V (Veetids) (see Penicillin V, [[Penicillin V]])
  • Procaine Penicillin

Penicillinase-Resistant Penicillins

  • Cloxacillin
  • Dicloxacillin (see Dicloxacillin, [[Dicloxacillin]])
  • Flucloxacillin (Floxapen, Staphylex, Softapen, Flubex, Flupen)
  • Methicillin (see Methicillin, [[Methicillin]])
  • Nafcillin (see Nafcillin, [[Nafcillin]])
  • Oxacillin (see Oxacillin, [[Oxacillin]])

Aminopenicillins

  • General Comments
    • Vulnerable to inactivation by β-lactamases
  • Amoxacillin (see Amoxacillin, [[Amoxacillin]]): due to potential inactivation by β-lactamases, usually used in a formulation with a β-lactamase inhibitor (like clavulanic acid)
  • Ampicillin (see Ampicillin, [[Ampicillin]]): due to potential inactivation by β-lactamases, usually used in a formulation with a β-lactamase inhibitor (like sulbactam)
  • Bacampicillin

Extended-Spectrum/Anti-Pseudomonal Penicillins

  • General Comments
    • Have activity against many gram-negative organisms of the Enterobacteriaceae family (including Pseudomonas aeruginosa)
    • Vulnerable to inactivation by β-lactamases
  • Acylaminopenicillins
    • Azlocillin
    • Mezlocillin
    • Piperacillin: due to potential inactivation by β-lactamases, usually used in a formulation with a β-lactamase inhibitor (like tazobactam)
  • Alpha-Carboxypenicillins
    • Carbenicillin
    • Ticarcillin: due to potential inactivation by β-lactamases, usually used in a formulation with a β-lactamase inhibitor (like clavulanic acid)

Adverse Effects

Pulmonary Adverse Effects

Dermatologic Adverse Effects

Other Adverse Effects


References

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