












Class of antibiotic |
Mode of action |
Resistance mechanisms |
|
β-lactams |
Penicillins |
Cell wall biosynthesis inhibitors eg piperacillin and ampicillin |
Breakdown by β-lactamases Altered penicillin binding protein targets Altered bacterial permeability |
Cephalosporins |
Cell wall biosynthesis inhibitors eg cefotaxime and cefadrine |
Breakdown by β-lactamases Breakdown by cephalosporinases |
|
Cephamycins |
Cell wall biosynthesis inhibitors eg cefoxitin |
Breakdown by β-lactamases | |
Carbapenems |
Cell wall biosynthesis inhibitors eg meropenem and imipenem |
Breakdown by β-lactamases Breakdown by dehydropeptidases |
|
Monobactams |
Cell wall biosynthesis inhibitors eg aztreonam |
Breakdown by β-lactamases | |
Glycopeptides |
Cell wall biosynthesis inhibitor eg vancomycin and teicoplanin |
Alteration of target | |
Fluoroquinolones |
DNA gyrase A and topoisomerase II inhibitors (preventing supercoiling) eg norfloxacin and ciprofloxacin |
Alteration of enzyme targets Efflux pumps Altered bacterial permeability |
|
Aminoglycosides |
Protein biosynthesis inhibitors eg amikacin and neomycin |
Enzymatic modification of antibiotic (adenylated, phosphorylated or acetylated by target bacteria) Alteration of ribosome target |
|
Chloramphenicol |
Protein biosynthesis inhibitors | Enzymatic modification of antibiotic (inactivated by chloramphenicol acetyltransferase) Altered cell wall permeability |
|
Macrolides |
Protein biosynthesis inhibitors eg erythromycin A, clarithromycin and azithromycin |
Alteration of 23S rRNA Enzymatic modification of antibiotic |
|
Streptogramins |
Protein biosynthesis inhibitors eg quinupristin and dalfopristin |
Alteration of ribosome target Active efflux Enzymatic modification of antibiotic |
|
Tetracyclines |
Protein biosynthesis inhibitors eg tetracycline and doxycycline |
Efflux pumps Alteration of ribosome target Altered bacterial permeability Enzymatic modification of antibiotic |
|
Sulphonamides |
Folic acid biosynthesis inhibitors | Altered bacterial permeability | |
Trimethoprim |
Folic acid biosynthesis inhibitor | Altered bacterial permeability | |
Polymyxins |
Disruption of cell membrane structure eg colistin (polymyxin E) and polymyxin B |
Altered bacterial permeability | |



