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Antibiotic - Wikipedia

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class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Usage subsection</span> </button> <ul id="toc-Usage-sublist" class="vector-toc-list"> <li id="toc-Medical_uses" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Medical_uses"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.1</span> <span>Medical uses</span> </div> </a> <ul id="toc-Medical_uses-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Routes_of_administration" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Routes_of_administration"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.2</span> <span>Routes of administration</span> </div> </a> <ul id="toc-Routes_of_administration-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Global_consumption" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Global_consumption"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.3</span> <span>Global consumption</span> </div> </a> <ul id="toc-Global_consumption-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Side_effects" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Side_effects"> <div class="vector-toc-text"> <span class="vector-toc-numb">3</span> <span>Side effects</span> </div> </a> <ul id="toc-Side_effects-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Interactions" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Interactions"> <div class="vector-toc-text"> <span class="vector-toc-numb">4</span> <span>Interactions</span> </div> </a> <button aria-controls="toc-Interactions-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Interactions subsection</span> </button> <ul id="toc-Interactions-sublist" class="vector-toc-list"> <li id="toc-Birth_control_pills" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Birth_control_pills"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.1</span> <span>Birth control pills</span> </div> </a> <ul id="toc-Birth_control_pills-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Alcohol" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Alcohol"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.2</span> <span>Alcohol</span> </div> </a> <ul id="toc-Alcohol-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Pharmacodynamics" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Pharmacodynamics"> <div class="vector-toc-text"> <span class="vector-toc-numb">5</span> <span>Pharmacodynamics</span> </div> </a> <button aria-controls="toc-Pharmacodynamics-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Pharmacodynamics subsection</span> </button> <ul id="toc-Pharmacodynamics-sublist" class="vector-toc-list"> <li id="toc-Combination_therapy" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Combination_therapy"> <div class="vector-toc-text"> <span class="vector-toc-numb">5.1</span> <span>Combination therapy</span> </div> </a> <ul id="toc-Combination_therapy-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Classes" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Classes"> <div class="vector-toc-text"> <span class="vector-toc-numb">6</span> <span>Classes</span> </div> </a> <ul id="toc-Classes-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Production" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Production"> <div class="vector-toc-text"> <span class="vector-toc-numb">7</span> <span>Production</span> </div> </a> <ul id="toc-Production-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Resistance" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Resistance"> <div class="vector-toc-text"> <span class="vector-toc-numb">8</span> <span>Resistance</span> </div> </a> <button aria-controls="toc-Resistance-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Resistance subsection</span> </button> <ul id="toc-Resistance-sublist" class="vector-toc-list"> <li id="toc-Misuse" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Misuse"> <div class="vector-toc-text"> <span class="vector-toc-numb">8.1</span> <span>Misuse</span> </div> </a> <ul id="toc-Misuse-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-History" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#History"> <div class="vector-toc-text"> <span class="vector-toc-numb">9</span> <span>History</span> </div> </a> <button aria-controls="toc-History-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle History subsection</span> </button> <ul id="toc-History-sublist" class="vector-toc-list"> <li id="toc-Synthetic_antibiotics_derived_from_dyes" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Synthetic_antibiotics_derived_from_dyes"> <div class="vector-toc-text"> <span class="vector-toc-numb">9.1</span> <span>Synthetic antibiotics derived from dyes</span> </div> </a> <ul id="toc-Synthetic_antibiotics_derived_from_dyes-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Penicillin_and_other_natural_antibiotics" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Penicillin_and_other_natural_antibiotics"> <div class="vector-toc-text"> <span class="vector-toc-numb">9.2</span> <span>Penicillin and other natural antibiotics</span> </div> </a> <ul id="toc-Penicillin_and_other_natural_antibiotics-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Late_20th_century" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Late_20th_century"> <div class="vector-toc-text"> <span class="vector-toc-numb">9.3</span> <span>Late 20th century</span> </div> </a> <ul id="toc-Late_20th_century-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Antibiotic_pipeline" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Antibiotic_pipeline"> <div class="vector-toc-text"> <span class="vector-toc-numb">10</span> <span>Antibiotic pipeline</span> </div> </a> <button aria-controls="toc-Antibiotic_pipeline-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Antibiotic pipeline subsection</span> </button> <ul id="toc-Antibiotic_pipeline-sublist" class="vector-toc-list"> <li id="toc-Replenishing_the_antibiotic_pipeline_and_developing_other_new_therapies" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Replenishing_the_antibiotic_pipeline_and_developing_other_new_therapies"> <div class="vector-toc-text"> <span class="vector-toc-numb">10.1</span> <span>Replenishing the antibiotic pipeline and developing other new therapies</span> </div> </a> <ul id="toc-Replenishing_the_antibiotic_pipeline_and_developing_other_new_therapies-sublist" class="vector-toc-list"> <li id="toc-Natural_product-based_antibiotic_discovery" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Natural_product-based_antibiotic_discovery"> <div class="vector-toc-text"> <span class="vector-toc-numb">10.1.1</span> <span>Natural product-based antibiotic discovery</span> </div> </a> <ul id="toc-Natural_product-based_antibiotic_discovery-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Immunoglobulin_therapy" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Immunoglobulin_therapy"> <div class="vector-toc-text"> <span class="vector-toc-numb">10.1.2</span> <span>Immunoglobulin therapy</span> </div> </a> <ul id="toc-Immunoglobulin_therapy-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Phage_therapy" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Phage_therapy"> <div class="vector-toc-text"> <span class="vector-toc-numb">10.1.3</span> <span>Phage therapy</span> </div> </a> <ul id="toc-Phage_therapy-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Fecal_microbiota_transplants" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Fecal_microbiota_transplants"> <div class="vector-toc-text"> <span class="vector-toc-numb">10.1.4</span> <span>Fecal microbiota transplants</span> </div> </a> <ul id="toc-Fecal_microbiota_transplants-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Antisense_RNA-based_treatments" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Antisense_RNA-based_treatments"> <div class="vector-toc-text"> <span class="vector-toc-numb">10.1.5</span> <span>Antisense RNA-based treatments</span> </div> </a> <ul id="toc-Antisense_RNA-based_treatments-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-CRISPR-Cas9-based_treatments" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#CRISPR-Cas9-based_treatments"> <div class="vector-toc-text"> <span class="vector-toc-numb">10.1.6</span> <span>CRISPR-Cas9-based treatments</span> </div> </a> <ul id="toc-CRISPR-Cas9-based_treatments-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Reducing_the_selection_pressure_for_antibiotic_resistance" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Reducing_the_selection_pressure_for_antibiotic_resistance"> <div class="vector-toc-text"> <span class="vector-toc-numb">10.2</span> <span>Reducing the selection pressure for antibiotic resistance</span> </div> </a> <ul id="toc-Reducing_the_selection_pressure_for_antibiotic_resistance-sublist" class="vector-toc-list"> <li id="toc-Vaccines" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Vaccines"> <div class="vector-toc-text"> <span class="vector-toc-numb">10.2.1</span> <span>Vaccines</span> </div> </a> <ul id="toc-Vaccines-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> </ul> </li> <li id="toc-See_also" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#See_also"> <div class="vector-toc-text"> <span class="vector-toc-numb">11</span> <span>See also</span> </div> </a> <ul id="toc-See_also-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-References" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#References"> <div class="vector-toc-text"> <span class="vector-toc-numb">12</span> <span>References</span> </div> </a> <ul id="toc-References-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Further_reading" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Further_reading"> <div class="vector-toc-text"> <span class="vector-toc-numb">13</span> <span>Further reading</span> </div> </a> <ul id="toc-Further_reading-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-External_links" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#External_links"> <div class="vector-toc-text"> <span class="vector-toc-numb">14</span> <span>External links</span> </div> </a> <ul id="toc-External_links-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav aria-label="Contents" class="vector-toc-landmark"> <div id="vector-page-titlebar-toc" class="vector-dropdown vector-page-titlebar-toc vector-button-flush-left" > <input type="checkbox" id="vector-page-titlebar-toc-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-vector-page-titlebar-toc" class="vector-dropdown-checkbox " aria-label="Toggle the table of contents" > <label id="vector-page-titlebar-toc-label" for="vector-page-titlebar-toc-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--icon-only " aria-hidden="true" ><span class="vector-icon mw-ui-icon-listBullet mw-ui-icon-wikimedia-listBullet"></span> <span class="vector-dropdown-label-text">Toggle the table of contents</span> </label> <div class="vector-dropdown-content"> <div id="vector-page-titlebar-toc-unpinned-container" class="vector-unpinned-container"> </div> </div> </div> </nav> <h1 id="firstHeading" class="firstHeading mw-first-heading"><span class="mw-page-title-main">Antibiotic</span></h1> <div id="p-lang-btn" class="vector-dropdown mw-portlet mw-portlet-lang" > <input type="checkbox" id="p-lang-btn-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-p-lang-btn" class="vector-dropdown-checkbox mw-interlanguage-selector" aria-label="Go to an article in another language. Available in 127 languages" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-127" aria-hidden="true" ><span class="vector-icon mw-ui-icon-language-progressive mw-ui-icon-wikimedia-language-progressive"></span> <span class="vector-dropdown-label-text">127 languages</span> </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-af mw-list-item"><a href="https://af.wikipedia.org/wiki/Antibiotikum" title="Antibiotikum – Afrikaans" lang="af" hreflang="af" data-title="Antibiotikum" data-language-autonym="Afrikaans" data-language-local-name="Afrikaans" class="interlanguage-link-target"><span>Afrikaans</span></a></li><li class="interlanguage-link interwiki-als mw-list-item"><a href="https://als.wikipedia.org/wiki/Antibiotikum" title="Antibiotikum – Alemannic" lang="gsw" hreflang="gsw" data-title="Antibiotikum" data-language-autonym="Alemannisch" data-language-local-name="Alemannic" class="interlanguage-link-target"><span>Alemannisch</span></a></li><li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D9%85%D8%B6%D8%A7%D8%AF_%D8%AD%D9%8A%D9%88%D9%8A" title="مضاد حيوي – Arabic" lang="ar" hreflang="ar" data-title="مضاد حيوي" data-language-autonym="العربية" data-language-local-name="Arabic" class="interlanguage-link-target"><span>العربية</span></a></li><li class="interlanguage-link interwiki-an mw-list-item"><a href="https://an.wikipedia.org/wiki/Antibiotico" title="Antibiotico – Aragonese" lang="an" hreflang="an" data-title="Antibiotico" data-language-autonym="Aragonés" data-language-local-name="Aragonese" class="interlanguage-link-target"><span>Aragonés</span></a></li><li class="interlanguage-link interwiki-hyw mw-list-item"><a href="https://hyw.wikipedia.org/wiki/%D4%B1%D5%B6%D5%A9%D5%AB%D5%BA%D5%AB%D5%B8%D5%A9%D5%AB%D6%84_(%D5%84%D5%A1%D5%B6%D6%80%D5%A7%D5%A1%D5%BD%D5%BA%D5%A1%D5%B6)" title="Անթիպիոթիք (Մանրէասպան) – Western Armenian" lang="hyw" hreflang="hyw" data-title="Անթիպիոթիք (Մանրէասպան)" data-language-autonym="Արեւմտահայերէն" data-language-local-name="Western Armenian" class="interlanguage-link-target"><span>Արեւմտահայերէն</span></a></li><li class="interlanguage-link interwiki-as mw-list-item"><a href="https://as.wikipedia.org/wiki/%E0%A6%AA%E0%A7%8D%E0%A7%B0%E0%A6%A4%E0%A6%BF%E0%A6%9C%E0%A7%88%E0%A7%B1%E0%A6%BF%E0%A6%95" title="প্ৰতিজৈৱিক – Assamese" lang="as" hreflang="as" data-title="প্ৰতিজৈৱিক" data-language-autonym="অসমীয়া" data-language-local-name="Assamese" class="interlanguage-link-target"><span>অসমীয়া</span></a></li><li class="interlanguage-link interwiki-ast mw-list-item"><a href="https://ast.wikipedia.org/wiki/Antibi%C3%B3ticu" title="Antibióticu – Asturian" lang="ast" hreflang="ast" data-title="Antibióticu" data-language-autonym="Asturianu" data-language-local-name="Asturian" class="interlanguage-link-target"><span>Asturianu</span></a></li><li class="interlanguage-link interwiki-gn mw-list-item"><a href="https://gn.wikipedia.org/wiki/Poh%C3%A3rekoitegua" title="Pohãrekoitegua – Guarani" lang="gn" hreflang="gn" data-title="Pohãrekoitegua" data-language-autonym="Avañe&#039;ẽ" data-language-local-name="Guarani" class="interlanguage-link-target"><span>Avañe'ẽ</span></a></li><li class="interlanguage-link interwiki-az mw-list-item"><a href="https://az.wikipedia.org/wiki/Antibiotikl%C9%99r" title="Antibiotiklər – Azerbaijani" lang="az" hreflang="az" data-title="Antibiotiklər" data-language-autonym="Azərbaycanca" data-language-local-name="Azerbaijani" class="interlanguage-link-target"><span>Azərbaycanca</span></a></li><li class="interlanguage-link interwiki-azb mw-list-item"><a href="https://azb.wikipedia.org/wiki/%D8%A2%D9%86%D8%AA%DB%8C%E2%80%8C%D8%A8%DB%8C%D9%88%D8%AA%DB%8C%DA%A9%E2%80%8C" title="آنتی‌بیوتیک‌ – South Azerbaijani" lang="azb" hreflang="azb" data-title="آنتی‌بیوتیک‌" data-language-autonym="تۆرکجه" data-language-local-name="South Azerbaijani" class="interlanguage-link-target"><span>تۆرکجه</span></a></li><li class="interlanguage-link interwiki-bn mw-list-item"><a href="https://bn.wikipedia.org/wiki/%E0%A6%85%E0%A7%8D%E0%A6%AF%E0%A6%BE%E0%A6%A8%E0%A7%8D%E0%A6%9F%E0%A6%BF%E0%A6%AC%E0%A6%BE%E0%A6%AF%E0%A6%BC%E0%A7%8B%E0%A6%9F%E0%A6%BF%E0%A6%95" title="অ্যান্টিবায়োটিক – Bangla" lang="bn" hreflang="bn" data-title="অ্যান্টিবায়োটিক" data-language-autonym="বাংলা" data-language-local-name="Bangla" class="interlanguage-link-target"><span>বাংলা</span></a></li><li class="interlanguage-link interwiki-zh-min-nan mw-list-item"><a href="https://zh-min-nan.wikipedia.org/wiki/Kh%C3%B2ng-seng-s%C3%B2%CD%98" title="Khòng-seng-sò͘ – Minnan" lang="nan" hreflang="nan" data-title="Khòng-seng-sò͘" data-language-autonym="閩南語 / Bân-lâm-gú" data-language-local-name="Minnan" class="interlanguage-link-target"><span>閩南語 / Bân-lâm-gú</span></a></li><li class="interlanguage-link interwiki-ba mw-list-item"><a href="https://ba.wikipedia.org/wiki/%D0%90%D0%BD%D1%82%D0%B8%D0%B1%D0%B8%D0%BE%D1%82%D0%B8%D0%BA%D1%82%D0%B0%D1%80" title="Антибиотиктар – Bashkir" lang="ba" hreflang="ba" data-title="Антибиотиктар" data-language-autonym="Башҡортса" data-language-local-name="Bashkir" class="interlanguage-link-target"><span>Башҡортса</span></a></li><li class="interlanguage-link interwiki-be mw-list-item"><a href="https://be.wikipedia.org/wiki/%D0%90%D0%BD%D1%82%D1%8B%D0%B1%D1%96%D1%91%D1%82%D1%8B%D0%BA%D1%96" title="Антыбіётыкі – Belarusian" lang="be" hreflang="be" data-title="Антыбіётыкі" data-language-autonym="Беларуская" data-language-local-name="Belarusian" class="interlanguage-link-target"><span>Беларуская</span></a></li><li class="interlanguage-link interwiki-be-x-old mw-list-item"><a href="https://be-tarask.wikipedia.org/wiki/%D0%90%D0%BD%D1%82%D1%8B%D0%B1%D1%96%D1%91%D1%82%D1%8B%D0%BA" title="Антыбіётык – Belarusian (Taraškievica orthography)" lang="be-tarask" hreflang="be-tarask" data-title="Антыбіётык" data-language-autonym="Беларуская (тарашкевіца)" data-language-local-name="Belarusian (Taraškievica orthography)" class="interlanguage-link-target"><span>Беларуская (тарашкевіца)</span></a></li><li class="interlanguage-link interwiki-bh mw-list-item"><a href="https://bh.wikipedia.org/wiki/%E0%A4%8F%E0%A4%82%E0%A4%9F%E0%A5%80%E0%A4%AC%E0%A4%BE%E0%A4%AF%E0%A5%8B%E0%A4%9F%E0%A4%BF%E0%A4%95" title="एंटीबायोटिक – Bhojpuri" lang="bh" hreflang="bh" data-title="एंटीबायोटिक" data-language-autonym="भोजपुरी" data-language-local-name="Bhojpuri" class="interlanguage-link-target"><span>भोजपुरी</span></a></li><li class="interlanguage-link interwiki-bg mw-list-item"><a href="https://bg.wikipedia.org/wiki/%D0%90%D0%BD%D1%82%D0%B8%D0%B1%D0%B8%D0%BE%D1%82%D0%B8%D0%BA" title="Антибиотик – Bulgarian" lang="bg" hreflang="bg" data-title="Антибиотик" data-language-autonym="Български" data-language-local-name="Bulgarian" class="interlanguage-link-target"><span>Български</span></a></li><li class="interlanguage-link interwiki-bs mw-list-item"><a href="https://bs.wikipedia.org/wiki/Antibiotik" title="Antibiotik – Bosnian" lang="bs" hreflang="bs" data-title="Antibiotik" data-language-autonym="Bosanski" data-language-local-name="Bosnian" class="interlanguage-link-target"><span>Bosanski</span></a></li><li class="interlanguage-link interwiki-br mw-list-item"><a href="https://br.wikipedia.org/wiki/Antibiotik" title="Antibiotik – Breton" lang="br" hreflang="br" data-title="Antibiotik" data-language-autonym="Brezhoneg" data-language-local-name="Breton" class="interlanguage-link-target"><span>Brezhoneg</span></a></li><li class="interlanguage-link interwiki-ca mw-list-item"><a href="https://ca.wikipedia.org/wiki/Antibi%C3%B2tic" title="Antibiòtic – Catalan" lang="ca" hreflang="ca" data-title="Antibiòtic" data-language-autonym="Català" data-language-local-name="Catalan" class="interlanguage-link-target"><span>Català</span></a></li><li class="interlanguage-link interwiki-cs mw-list-item"><a href="https://cs.wikipedia.org/wiki/Antibiotikum" title="Antibiotikum – Czech" lang="cs" hreflang="cs" data-title="Antibiotikum" data-language-autonym="Čeština" data-language-local-name="Czech" class="interlanguage-link-target"><span>Čeština</span></a></li><li class="interlanguage-link interwiki-cy mw-list-item"><a href="https://cy.wikipedia.org/wiki/Gwrthfiotig" title="Gwrthfiotig – Welsh" lang="cy" hreflang="cy" data-title="Gwrthfiotig" data-language-autonym="Cymraeg" data-language-local-name="Welsh" class="interlanguage-link-target"><span>Cymraeg</span></a></li><li class="interlanguage-link interwiki-da mw-list-item"><a href="https://da.wikipedia.org/wiki/Antibiotikum" title="Antibiotikum – Danish" lang="da" hreflang="da" data-title="Antibiotikum" data-language-autonym="Dansk" data-language-local-name="Danish" class="interlanguage-link-target"><span>Dansk</span></a></li><li class="interlanguage-link interwiki-ary mw-list-item"><a href="https://ary.wikipedia.org/wiki/%D8%A4%D9%86%D8%AA%D9%8A%D8%A8%D9%8A%D9%88%D8%AA%D9%8A%D9%83" title="ؤنتيبيوتيك – Moroccan Arabic" lang="ary" hreflang="ary" data-title="ؤنتيبيوتيك" data-language-autonym="الدارجة" data-language-local-name="Moroccan Arabic" class="interlanguage-link-target"><span>الدارجة</span></a></li><li class="interlanguage-link interwiki-se mw-list-item"><a href="https://se.wikipedia.org/wiki/Antibiohta" title="Antibiohta – Northern Sami" lang="se" hreflang="se" data-title="Antibiohta" data-language-autonym="Davvisámegiella" data-language-local-name="Northern Sami" class="interlanguage-link-target"><span>Davvisámegiella</span></a></li><li class="interlanguage-link interwiki-de mw-list-item"><a href="https://de.wikipedia.org/wiki/Antibiotikum" title="Antibiotikum – German" lang="de" hreflang="de" data-title="Antibiotikum" data-language-autonym="Deutsch" data-language-local-name="German" class="interlanguage-link-target"><span>Deutsch</span></a></li><li class="interlanguage-link interwiki-et mw-list-item"><a href="https://et.wikipedia.org/wiki/Antibiootikumid" title="Antibiootikumid – Estonian" lang="et" hreflang="et" data-title="Antibiootikumid" data-language-autonym="Eesti" data-language-local-name="Estonian" class="interlanguage-link-target"><span>Eesti</span></a></li><li class="interlanguage-link interwiki-el mw-list-item"><a href="https://el.wikipedia.org/wiki/%CE%91%CE%BD%CF%84%CE%B9%CE%B2%CE%B9%CE%BF%CF%84%CE%B9%CE%BA%CF%8C" title="Αντιβιοτικό – Greek" lang="el" hreflang="el" data-title="Αντιβιοτικό" data-language-autonym="Ελληνικά" data-language-local-name="Greek" class="interlanguage-link-target"><span>Ελληνικά</span></a></li><li class="interlanguage-link interwiki-eml mw-list-item"><a href="https://eml.wikipedia.org/wiki/Antibi%C3%B2tic" title="Antibiòtic – Emiliano-Romagnolo" lang="egl" hreflang="egl" data-title="Antibiòtic" data-language-autonym="Emiliàn e rumagnòl" data-language-local-name="Emiliano-Romagnolo" class="interlanguage-link-target"><span>Emiliàn e rumagnòl</span></a></li><li class="interlanguage-link interwiki-es badge-Q17437796 badge-featuredarticle mw-list-item" title="featured article badge"><a href="https://es.wikipedia.org/wiki/Antibi%C3%B3tico" title="Antibiótico – Spanish" lang="es" hreflang="es" data-title="Antibiótico" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target"><span>Español</span></a></li><li class="interlanguage-link interwiki-eo mw-list-item"><a href="https://eo.wikipedia.org/wiki/Antibiotiko" title="Antibiotiko – Esperanto" lang="eo" hreflang="eo" data-title="Antibiotiko" data-language-autonym="Esperanto" data-language-local-name="Esperanto" class="interlanguage-link-target"><span>Esperanto</span></a></li><li class="interlanguage-link interwiki-ext mw-list-item"><a href="https://ext.wikipedia.org/wiki/Antibi%C3%B3ticu" title="Antibióticu – Extremaduran" lang="ext" hreflang="ext" data-title="Antibióticu" data-language-autonym="Estremeñu" data-language-local-name="Extremaduran" class="interlanguage-link-target"><span>Estremeñu</span></a></li><li class="interlanguage-link interwiki-eu mw-list-item"><a href="https://eu.wikipedia.org/wiki/Antibiotiko" title="Antibiotiko – Basque" lang="eu" hreflang="eu" data-title="Antibiotiko" data-language-autonym="Euskara" data-language-local-name="Basque" class="interlanguage-link-target"><span>Euskara</span></a></li><li class="interlanguage-link interwiki-fa mw-list-item"><a href="https://fa.wikipedia.org/wiki/%D8%A2%D9%86%D8%AA%DB%8C%E2%80%8C%D8%A8%DB%8C%D9%88%D8%AA%DB%8C%DA%A9" title="آنتی‌بیوتیک – Persian" lang="fa" hreflang="fa" data-title="آنتی‌بیوتیک" data-language-autonym="فارسی" data-language-local-name="Persian" class="interlanguage-link-target"><span>فارسی</span></a></li><li class="interlanguage-link interwiki-hif mw-list-item"><a href="https://hif.wikipedia.org/wiki/Antibiotic" title="Antibiotic – Fiji Hindi" lang="hif" hreflang="hif" data-title="Antibiotic" data-language-autonym="Fiji Hindi" data-language-local-name="Fiji Hindi" class="interlanguage-link-target"><span>Fiji Hindi</span></a></li><li class="interlanguage-link interwiki-fo mw-list-item"><a href="https://fo.wikipedia.org/wiki/Antibiotika" title="Antibiotika – Faroese" lang="fo" hreflang="fo" data-title="Antibiotika" data-language-autonym="Føroyskt" data-language-local-name="Faroese" class="interlanguage-link-target"><span>Føroyskt</span></a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/Antibiotique" title="Antibiotique – French" lang="fr" hreflang="fr" data-title="Antibiotique" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target"><span>Français</span></a></li><li class="interlanguage-link interwiki-fy mw-list-item"><a href="https://fy.wikipedia.org/wiki/Antibioatikum" title="Antibioatikum – Western Frisian" lang="fy" hreflang="fy" data-title="Antibioatikum" data-language-autonym="Frysk" data-language-local-name="Western Frisian" class="interlanguage-link-target"><span>Frysk</span></a></li><li class="interlanguage-link interwiki-ga mw-list-item"><a href="https://ga.wikipedia.org/wiki/Antaibheathach" title="Antaibheathach – Irish" lang="ga" hreflang="ga" data-title="Antaibheathach" data-language-autonym="Gaeilge" data-language-local-name="Irish" class="interlanguage-link-target"><span>Gaeilge</span></a></li><li class="interlanguage-link interwiki-gl mw-list-item"><a href="https://gl.wikipedia.org/wiki/Antibi%C3%B3tico" title="Antibiótico – Galician" lang="gl" hreflang="gl" data-title="Antibiótico" data-language-autonym="Galego" data-language-local-name="Galician" class="interlanguage-link-target"><span>Galego</span></a></li><li class="interlanguage-link interwiki-ko mw-list-item"><a href="https://ko.wikipedia.org/wiki/%ED%95%AD%EC%83%9D%EC%A0%9C" title="항생제 – Korean" lang="ko" hreflang="ko" data-title="항생제" data-language-autonym="한국어" data-language-local-name="Korean" class="interlanguage-link-target"><span>한국어</span></a></li><li class="interlanguage-link interwiki-hy mw-list-item"><a href="https://hy.wikipedia.org/wiki/%D5%80%D5%A1%D5%AF%D5%A1%D5%A2%D5%AB%D5%B8%D5%BF%D5%AB%D5%AF" title="Հակաբիոտիկ – Armenian" lang="hy" hreflang="hy" data-title="Հակաբիոտիկ" data-language-autonym="Հայերեն" data-language-local-name="Armenian" class="interlanguage-link-target"><span>Հայերեն</span></a></li><li class="interlanguage-link interwiki-hi mw-list-item"><a href="https://hi.wikipedia.org/wiki/%E0%A4%AA%E0%A5%8D%E0%A4%B0%E0%A4%A4%E0%A4%BF%E0%A4%9C%E0%A5%88%E0%A4%B5%E0%A4%BF%E0%A4%95" title="प्रतिजैविक – Hindi" lang="hi" hreflang="hi" data-title="प्रतिजैविक" data-language-autonym="हिन्दी" data-language-local-name="Hindi" class="interlanguage-link-target"><span>हिन्दी</span></a></li><li class="interlanguage-link interwiki-hr mw-list-item"><a href="https://hr.wikipedia.org/wiki/Antibiotik" title="Antibiotik – Croatian" lang="hr" hreflang="hr" data-title="Antibiotik" data-language-autonym="Hrvatski" data-language-local-name="Croatian" class="interlanguage-link-target"><span>Hrvatski</span></a></li><li class="interlanguage-link interwiki-io mw-list-item"><a href="https://io.wikipedia.org/wiki/Antibiotiko" title="Antibiotiko – Ido" lang="io" hreflang="io" data-title="Antibiotiko" data-language-autonym="Ido" data-language-local-name="Ido" class="interlanguage-link-target"><span>Ido</span></a></li><li class="interlanguage-link interwiki-id mw-list-item"><a href="https://id.wikipedia.org/wiki/Antibiotik" title="Antibiotik – Indonesian" lang="id" hreflang="id" data-title="Antibiotik" data-language-autonym="Bahasa Indonesia" data-language-local-name="Indonesian" class="interlanguage-link-target"><span>Bahasa Indonesia</span></a></li><li class="interlanguage-link interwiki-ia mw-list-item"><a href="https://ia.wikipedia.org/wiki/Antibiotico" title="Antibiotico – Interlingua" lang="ia" hreflang="ia" data-title="Antibiotico" data-language-autonym="Interlingua" data-language-local-name="Interlingua" class="interlanguage-link-target"><span>Interlingua</span></a></li><li class="interlanguage-link interwiki-zu mw-list-item"><a href="https://zu.wikipedia.org/wiki/IsiNqandagciwane" title="IsiNqandagciwane – Zulu" lang="zu" hreflang="zu" data-title="IsiNqandagciwane" data-language-autonym="IsiZulu" data-language-local-name="Zulu" class="interlanguage-link-target"><span>IsiZulu</span></a></li><li class="interlanguage-link interwiki-is mw-list-item"><a href="https://is.wikipedia.org/wiki/S%C3%BDklalyf" title="Sýklalyf – Icelandic" lang="is" hreflang="is" data-title="Sýklalyf" data-language-autonym="Íslenska" data-language-local-name="Icelandic" class="interlanguage-link-target"><span>Íslenska</span></a></li><li class="interlanguage-link interwiki-it mw-list-item"><a href="https://it.wikipedia.org/wiki/Antibiotico" title="Antibiotico – Italian" lang="it" hreflang="it" data-title="Antibiotico" data-language-autonym="Italiano" data-language-local-name="Italian" class="interlanguage-link-target"><span>Italiano</span></a></li><li class="interlanguage-link interwiki-he mw-list-item"><a href="https://he.wikipedia.org/wiki/%D7%90%D7%A0%D7%98%D7%99%D7%91%D7%99%D7%95%D7%98%D7%99%D7%A7%D7%94" title="אנטיביוטיקה – Hebrew" lang="he" hreflang="he" data-title="אנטיביוטיקה" data-language-autonym="עברית" data-language-local-name="Hebrew" class="interlanguage-link-target"><span>עברית</span></a></li><li class="interlanguage-link interwiki-jv mw-list-item"><a href="https://jv.wikipedia.org/wiki/Antibiotik" title="Antibiotik – Javanese" lang="jv" hreflang="jv" data-title="Antibiotik" data-language-autonym="Jawa" data-language-local-name="Javanese" class="interlanguage-link-target"><span>Jawa</span></a></li><li class="interlanguage-link interwiki-kn mw-list-item"><a href="https://kn.wikipedia.org/wiki/%E0%B2%AA%E0%B3%8D%E0%B2%B0%E0%B2%A4%E0%B2%BF%E0%B2%9C%E0%B3%80%E0%B2%B5%E0%B2%BF%E0%B2%95" title="ಪ್ರತಿಜೀವಿಕ – Kannada" lang="kn" hreflang="kn" data-title="ಪ್ರತಿಜೀವಿಕ" data-language-autonym="ಕನ್ನಡ" data-language-local-name="Kannada" class="interlanguage-link-target"><span>ಕನ್ನಡ</span></a></li><li class="interlanguage-link interwiki-ka mw-list-item"><a href="https://ka.wikipedia.org/wiki/%E1%83%90%E1%83%9C%E1%83%A2%E1%83%98%E1%83%91%E1%83%98%E1%83%9D%E1%83%A2%E1%83%98%E1%83%99%E1%83%94%E1%83%91%E1%83%98" title="ანტიბიოტიკები – Georgian" lang="ka" hreflang="ka" data-title="ანტიბიოტიკები" data-language-autonym="ქართული" data-language-local-name="Georgian" class="interlanguage-link-target"><span>ქართული</span></a></li><li class="interlanguage-link interwiki-ks mw-list-item"><a href="https://ks.wikipedia.org/wiki/%D8%A7%DB%8C%D9%86%D9%B9%DB%8C_%D8%A8%D9%8E%DB%8C%D8%A7%D9%B9%D9%90%DA%A9%D8%B3" title="اینٹی بَیاٹِکس – Kashmiri" lang="ks" hreflang="ks" data-title="اینٹی بَیاٹِکس" data-language-autonym="कॉशुर / کٲشُر" data-language-local-name="Kashmiri" class="interlanguage-link-target"><span>कॉशुर / کٲشُر</span></a></li><li class="interlanguage-link interwiki-kk mw-list-item"><a href="https://kk.wikipedia.org/wiki/%D0%90%D0%BD%D1%82%D0%B8%D0%B1%D0%B8%D0%BE%D1%82%D0%B8%D0%BA" title="Антибиотик – Kazakh" lang="kk" hreflang="kk" data-title="Антибиотик" data-language-autonym="Қазақша" data-language-local-name="Kazakh" class="interlanguage-link-target"><span>Қазақша</span></a></li><li class="interlanguage-link interwiki-sw mw-list-item"><a href="https://sw.wikipedia.org/wiki/Antibiotiki" title="Antibiotiki – Swahili" lang="sw" hreflang="sw" data-title="Antibiotiki" data-language-autonym="Kiswahili" data-language-local-name="Swahili" class="interlanguage-link-target"><span>Kiswahili</span></a></li><li class="interlanguage-link interwiki-ht mw-list-item"><a href="https://ht.wikipedia.org/wiki/Antibiyotik" title="Antibiyotik – Haitian Creole" lang="ht" hreflang="ht" data-title="Antibiyotik" data-language-autonym="Kreyòl ayisyen" data-language-local-name="Haitian Creole" class="interlanguage-link-target"><span>Kreyòl ayisyen</span></a></li><li class="interlanguage-link interwiki-gcr mw-list-item"><a href="https://gcr.wikipedia.org/wiki/Antibyotik" title="Antibyotik – Guianan Creole" lang="gcr" hreflang="gcr" data-title="Antibyotik" data-language-autonym="Kriyòl gwiyannen" data-language-local-name="Guianan Creole" class="interlanguage-link-target"><span>Kriyòl gwiyannen</span></a></li><li class="interlanguage-link interwiki-ku mw-list-item"><a href="https://ku.wikipedia.org/wiki/Derman%C3%AAn_dijbakter%C3%AE" title="Dermanên dijbakterî – Kurdish" lang="ku" hreflang="ku" data-title="Dermanên dijbakterî" data-language-autonym="Kurdî" data-language-local-name="Kurdish" class="interlanguage-link-target"><span>Kurdî</span></a></li><li class="interlanguage-link interwiki-ky mw-list-item"><a href="https://ky.wikipedia.org/wiki/%D0%90%D0%BD%D1%82%D0%B8%D0%B1%D0%B8%D0%BE%D1%82%D0%B8%D0%BA" title="Антибиотик – Kyrgyz" lang="ky" hreflang="ky" data-title="Антибиотик" data-language-autonym="Кыргызча" data-language-local-name="Kyrgyz" class="interlanguage-link-target"><span>Кыргызча</span></a></li><li class="interlanguage-link interwiki-lo mw-list-item"><a href="https://lo.wikipedia.org/wiki/%E0%BA%A2%E0%BA%B2%E0%BA%95%E0%BB%89%E0%BA%B2%E0%BA%99%E0%BB%80%E0%BA%8A%E0%BA%B7%E0%BB%89%E0%BA%AD" title="ຢາຕ້ານເຊື້ອ – Lao" lang="lo" hreflang="lo" data-title="ຢາຕ້ານເຊື້ອ" data-language-autonym="ລາວ" data-language-local-name="Lao" class="interlanguage-link-target"><span>ລາວ</span></a></li><li class="interlanguage-link interwiki-la mw-list-item"><a href="https://la.wikipedia.org/wiki/Antibioticum" title="Antibioticum – Latin" lang="la" hreflang="la" data-title="Antibioticum" data-language-autonym="Latina" data-language-local-name="Latin" class="interlanguage-link-target"><span>Latina</span></a></li><li class="interlanguage-link interwiki-lv mw-list-item"><a href="https://lv.wikipedia.org/wiki/Antibiotikas" title="Antibiotikas – Latvian" lang="lv" hreflang="lv" data-title="Antibiotikas" data-language-autonym="Latviešu" data-language-local-name="Latvian" class="interlanguage-link-target"><span>Latviešu</span></a></li><li class="interlanguage-link interwiki-lt mw-list-item"><a href="https://lt.wikipedia.org/wiki/Antibiotikas" title="Antibiotikas – Lithuanian" lang="lt" hreflang="lt" data-title="Antibiotikas" data-language-autonym="Lietuvių" data-language-local-name="Lithuanian" class="interlanguage-link-target"><span>Lietuvių</span></a></li><li class="interlanguage-link interwiki-li mw-list-item"><a href="https://li.wikipedia.org/wiki/Antibiotica" title="Antibiotica – Limburgish" lang="li" hreflang="li" data-title="Antibiotica" data-language-autonym="Limburgs" data-language-local-name="Limburgish" class="interlanguage-link-target"><span>Limburgs</span></a></li><li class="interlanguage-link interwiki-ln mw-list-item"><a href="https://ln.wikipedia.org/wiki/At%C3%ADbyot%C3%ADki" title="Atíbyotíki – Lingala" lang="ln" hreflang="ln" data-title="Atíbyotíki" data-language-autonym="Lingála" data-language-local-name="Lingala" class="interlanguage-link-target"><span>Lingála</span></a></li><li class="interlanguage-link interwiki-lfn mw-list-item"><a href="https://lfn.wikipedia.org/wiki/Antibaterial" title="Antibaterial – Lingua Franca Nova" lang="lfn" hreflang="lfn" data-title="Antibaterial" data-language-autonym="Lingua Franca Nova" data-language-local-name="Lingua Franca Nova" class="interlanguage-link-target"><span>Lingua Franca Nova</span></a></li><li class="interlanguage-link interwiki-lmo mw-list-item"><a href="https://lmo.wikipedia.org/wiki/Antibioteg" title="Antibioteg – Lombard" lang="lmo" hreflang="lmo" data-title="Antibioteg" data-language-autonym="Lombard" data-language-local-name="Lombard" class="interlanguage-link-target"><span>Lombard</span></a></li><li class="interlanguage-link interwiki-hu mw-list-item"><a href="https://hu.wikipedia.org/wiki/Antibiotikum" title="Antibiotikum – Hungarian" lang="hu" hreflang="hu" data-title="Antibiotikum" data-language-autonym="Magyar" data-language-local-name="Hungarian" class="interlanguage-link-target"><span>Magyar</span></a></li><li class="interlanguage-link interwiki-mk mw-list-item"><a href="https://mk.wikipedia.org/wiki/%D0%90%D0%BD%D1%82%D0%B8%D0%B1%D0%B8%D0%BE%D1%82%D0%B8%D0%BA" title="Антибиотик – Macedonian" lang="mk" hreflang="mk" data-title="Антибиотик" data-language-autonym="Македонски" data-language-local-name="Macedonian" class="interlanguage-link-target"><span>Македонски</span></a></li><li class="interlanguage-link interwiki-mg mw-list-item"><a href="https://mg.wikipedia.org/wiki/Antibiotika" title="Antibiotika – Malagasy" lang="mg" hreflang="mg" data-title="Antibiotika" data-language-autonym="Malagasy" data-language-local-name="Malagasy" class="interlanguage-link-target"><span>Malagasy</span></a></li><li class="interlanguage-link interwiki-ml mw-list-item"><a href="https://ml.wikipedia.org/wiki/%E0%B4%86%E0%B4%A8%E0%B5%8D%E0%B4%B1%E0%B4%BF%E0%B4%AC%E0%B4%AF%E0%B5%8B%E0%B4%9F%E0%B5%8D%E0%B4%9F%E0%B4%BF%E0%B4%95%E0%B5%8D%E0%B4%95%E0%B5%8D" title="ആന്റിബയോട്ടിക്ക് – Malayalam" lang="ml" hreflang="ml" data-title="ആന്റിബയോട്ടിക്ക്" data-language-autonym="മലയാളം" data-language-local-name="Malayalam" class="interlanguage-link-target"><span>മലയാളം</span></a></li><li class="interlanguage-link interwiki-mr mw-list-item"><a href="https://mr.wikipedia.org/wiki/%E0%A4%AA%E0%A5%8D%E0%A4%B0%E0%A4%A4%E0%A4%BF%E0%A4%9C%E0%A5%88%E0%A4%B5%E0%A4%BF%E0%A4%95" title="प्रतिजैविक – Marathi" lang="mr" hreflang="mr" data-title="प्रतिजैविक" data-language-autonym="मराठी" data-language-local-name="Marathi" class="interlanguage-link-target"><span>मराठी</span></a></li><li class="interlanguage-link interwiki-mnw mw-list-item"><a href="https://mnw.wikipedia.org/wiki/%E1%80%A1%E1%80%AC%E1%80%94%E1%80%B9%E1%80%90%E1%80%AD%E1%80%97%E1%80%AD%E1%80%9E%E1%80%BC%E1%80%90%E1%80%AD%E1%80%85%E1%80%BA" title="အာန္တိဗိသြတိစ် – Mon" lang="mnw" hreflang="mnw" data-title="အာန္တိဗိသြတိစ်" data-language-autonym="ဘာသာမန်" data-language-local-name="Mon" class="interlanguage-link-target"><span>ဘာသာမန်</span></a></li><li class="interlanguage-link interwiki-ms mw-list-item"><a href="https://ms.wikipedia.org/wiki/Antibiotik" title="Antibiotik – Malay" lang="ms" hreflang="ms" data-title="Antibiotik" data-language-autonym="Bahasa Melayu" data-language-local-name="Malay" class="interlanguage-link-target"><span>Bahasa Melayu</span></a></li><li class="interlanguage-link interwiki-mdf mw-list-item"><a href="https://mdf.wikipedia.org/wiki/%D0%90%D0%BD%D1%82%D0%B8%D0%B1%D0%B8%D0%BE%D1%82%D0%B8%D0%BA%D0%BD%D0%B5" title="Антибиотикне – Moksha" lang="mdf" hreflang="mdf" data-title="Антибиотикне" data-language-autonym="Мокшень" data-language-local-name="Moksha" class="interlanguage-link-target"><span>Мокшень</span></a></li><li class="interlanguage-link interwiki-mn mw-list-item"><a href="https://mn.wikipedia.org/wiki/%D0%90%D0%BD%D1%82%D0%B8%D0%B1%D0%B8%D0%BE%D1%82%D0%B8%D0%BA" title="Антибиотик – Mongolian" lang="mn" hreflang="mn" data-title="Антибиотик" data-language-autonym="Монгол" data-language-local-name="Mongolian" class="interlanguage-link-target"><span>Монгол</span></a></li><li class="interlanguage-link interwiki-my mw-list-item"><a href="https://my.wikipedia.org/wiki/%E1%80%95%E1%80%8B%E1%80%AD%E1%80%87%E1%80%AE%E1%80%9D%E1%80%86%E1%80%B1%E1%80%B8%E1%80%99%E1%80%BB%E1%80%AC%E1%80%B8" title="ပဋိဇီဝဆေးများ – Burmese" lang="my" hreflang="my" data-title="ပဋိဇီဝဆေးများ" data-language-autonym="မြန်မာဘာသာ" data-language-local-name="Burmese" class="interlanguage-link-target"><span>မြန်မာဘာသာ</span></a></li><li class="interlanguage-link interwiki-nl mw-list-item"><a href="https://nl.wikipedia.org/wiki/Antibioticum" title="Antibioticum – Dutch" lang="nl" hreflang="nl" data-title="Antibioticum" data-language-autonym="Nederlands" data-language-local-name="Dutch" class="interlanguage-link-target"><span>Nederlands</span></a></li><li class="interlanguage-link interwiki-ne mw-list-item"><a href="https://ne.wikipedia.org/wiki/%E0%A4%8F%E0%A4%A8%E0%A5%8D%E0%A4%9F%E0%A4%BF%E0%A4%AC%E0%A4%BE%E0%A4%AF%E0%A5%8B%E0%A4%9F%E0%A4%BF%E0%A4%95" title="एन्टिबायोटिक – Nepali" lang="ne" hreflang="ne" data-title="एन्टिबायोटिक" data-language-autonym="नेपाली" data-language-local-name="Nepali" class="interlanguage-link-target"><span>नेपाली</span></a></li><li class="interlanguage-link interwiki-ja badge-Q17437796 badge-featuredarticle mw-list-item" title="featured article badge"><a href="https://ja.wikipedia.org/wiki/%E6%8A%97%E7%94%9F%E7%89%A9%E8%B3%AA" title="抗生物質 – Japanese" lang="ja" hreflang="ja" data-title="抗生物質" data-language-autonym="日本語" data-language-local-name="Japanese" class="interlanguage-link-target"><span>日本語</span></a></li><li class="interlanguage-link interwiki-frr mw-list-item"><a href="https://frr.wikipedia.org/wiki/Antibiotikum" title="Antibiotikum – Northern Frisian" lang="frr" hreflang="frr" data-title="Antibiotikum" data-language-autonym="Nordfriisk" data-language-local-name="Northern Frisian" class="interlanguage-link-target"><span>Nordfriisk</span></a></li><li class="interlanguage-link interwiki-no mw-list-item"><a href="https://no.wikipedia.org/wiki/Antibiotika" title="Antibiotika – Norwegian Bokmål" lang="nb" hreflang="nb" data-title="Antibiotika" data-language-autonym="Norsk bokmål" data-language-local-name="Norwegian Bokmål" class="interlanguage-link-target"><span>Norsk bokmål</span></a></li><li class="interlanguage-link interwiki-nn mw-list-item"><a href="https://nn.wikipedia.org/wiki/Antibiotikum" title="Antibiotikum – Norwegian Nynorsk" lang="nn" hreflang="nn" data-title="Antibiotikum" data-language-autonym="Norsk nynorsk" data-language-local-name="Norwegian Nynorsk" class="interlanguage-link-target"><span>Norsk nynorsk</span></a></li><li class="interlanguage-link interwiki-oc mw-list-item"><a href="https://oc.wikipedia.org/wiki/Antibiotic" title="Antibiotic – Occitan" lang="oc" hreflang="oc" data-title="Antibiotic" data-language-autonym="Occitan" data-language-local-name="Occitan" class="interlanguage-link-target"><span>Occitan</span></a></li><li class="interlanguage-link interwiki-uz mw-list-item"><a href="https://uz.wikipedia.org/wiki/Antibiotiklar" title="Antibiotiklar – Uzbek" lang="uz" hreflang="uz" data-title="Antibiotiklar" data-language-autonym="Oʻzbekcha / ўзбекча" data-language-local-name="Uzbek" class="interlanguage-link-target"><span>Oʻzbekcha / ўзбекча</span></a></li><li class="interlanguage-link interwiki-pa mw-list-item"><a href="https://pa.wikipedia.org/wiki/%E0%A8%AC%E0%A9%88%E0%A8%95%E0%A8%9F%E0%A9%80%E0%A8%B0%E0%A9%80%E0%A8%86-%E0%A8%B5%E0%A8%BF%E0%A8%B0%E0%A9%8B%E0%A8%A7%E0%A9%80_%E0%A8%A6%E0%A8%B5%E0%A8%BE%E0%A8%88" title="ਬੈਕਟੀਰੀਆ-ਵਿਰੋਧੀ ਦਵਾਈ – Punjabi" lang="pa" hreflang="pa" data-title="ਬੈਕਟੀਰੀਆ-ਵਿਰੋਧੀ ਦਵਾਈ" data-language-autonym="ਪੰਜਾਬੀ" data-language-local-name="Punjabi" class="interlanguage-link-target"><span>ਪੰਜਾਬੀ</span></a></li><li class="interlanguage-link interwiki-pnb mw-list-item"><a href="https://pnb.wikipedia.org/wiki/%D8%A7%D9%86%D9%B9%DB%8C_%D8%A8%D8%A7%DB%8C%D9%88%D9%B9%DA%A9" title="انٹی بایوٹک – Western Punjabi" lang="pnb" hreflang="pnb" data-title="انٹی بایوٹک" data-language-autonym="پنجابی" data-language-local-name="Western Punjabi" class="interlanguage-link-target"><span>پنجابی</span></a></li><li class="interlanguage-link interwiki-ps mw-list-item"><a href="https://ps.wikipedia.org/wiki/%D8%A7%D9%86%D9%BC%D9%8A%D8%A8%D8%A7%D9%8A%D9%88%D9%BC%D9%8A%DA%A9" title="انټيبايوټيک – Pashto" lang="ps" hreflang="ps" data-title="انټيبايوټيک" data-language-autonym="پښتو" data-language-local-name="Pashto" class="interlanguage-link-target"><span>پښتو</span></a></li><li class="interlanguage-link interwiki-jam mw-list-item"><a href="https://jam.wikipedia.org/wiki/Antibayatix" title="Antibayatix – Jamaican Creole English" lang="jam" hreflang="jam" data-title="Antibayatix" data-language-autonym="Patois" data-language-local-name="Jamaican Creole English" class="interlanguage-link-target"><span>Patois</span></a></li><li class="interlanguage-link interwiki-nds mw-list-item"><a href="https://nds.wikipedia.org/wiki/Antibiotikum" title="Antibiotikum – Low German" lang="nds" hreflang="nds" data-title="Antibiotikum" data-language-autonym="Plattdüütsch" data-language-local-name="Low German" class="interlanguage-link-target"><span>Plattdüütsch</span></a></li><li class="interlanguage-link interwiki-pl mw-list-item"><a href="https://pl.wikipedia.org/wiki/Antybiotyki" title="Antybiotyki – Polish" lang="pl" hreflang="pl" data-title="Antybiotyki" data-language-autonym="Polski" data-language-local-name="Polish" class="interlanguage-link-target"><span>Polski</span></a></li><li class="interlanguage-link interwiki-pt mw-list-item"><a href="https://pt.wikipedia.org/wiki/Antibi%C3%B3tico" title="Antibiótico – Portuguese" lang="pt" hreflang="pt" data-title="Antibiótico" data-language-autonym="Português" data-language-local-name="Portuguese" class="interlanguage-link-target"><span>Português</span></a></li><li class="interlanguage-link interwiki-ro mw-list-item"><a href="https://ro.wikipedia.org/wiki/Antibiotic" title="Antibiotic – Romanian" lang="ro" hreflang="ro" data-title="Antibiotic" data-language-autonym="Română" data-language-local-name="Romanian" class="interlanguage-link-target"><span>Română</span></a></li><li class="interlanguage-link interwiki-qu mw-list-item"><a href="https://qu.wikipedia.org/wiki/Unquy_muhu_wa%C3%B1uchiq" title="Unquy muhu wañuchiq – Quechua" lang="qu" hreflang="qu" data-title="Unquy muhu wañuchiq" data-language-autonym="Runa Simi" data-language-local-name="Quechua" class="interlanguage-link-target"><span>Runa Simi</span></a></li><li class="interlanguage-link interwiki-ru mw-list-item"><a href="https://ru.wikipedia.org/wiki/%D0%90%D0%BD%D1%82%D0%B8%D0%B1%D0%B8%D0%BE%D1%82%D0%B8%D0%BA%D0%B8" title="Антибиотики – Russian" lang="ru" hreflang="ru" data-title="Антибиотики" data-language-autonym="Русский" data-language-local-name="Russian" class="interlanguage-link-target"><span>Русский</span></a></li><li class="interlanguage-link interwiki-sah mw-list-item"><a href="https://sah.wikipedia.org/wiki/%D0%90%D0%BD%D1%82%D0%B8%D0%B1%D0%B8%D0%BE%D1%82%D0%B8%D0%BA" title="Антибиотик – Yakut" lang="sah" hreflang="sah" data-title="Антибиотик" data-language-autonym="Саха тыла" data-language-local-name="Yakut" class="interlanguage-link-target"><span>Саха тыла</span></a></li><li class="interlanguage-link interwiki-sco mw-list-item"><a href="https://sco.wikipedia.org/wiki/Antibiotics" title="Antibiotics – Scots" lang="sco" hreflang="sco" data-title="Antibiotics" data-language-autonym="Scots" data-language-local-name="Scots" class="interlanguage-link-target"><span>Scots</span></a></li><li class="interlanguage-link interwiki-sq mw-list-item"><a href="https://sq.wikipedia.org/wiki/Antibiotiku" title="Antibiotiku – Albanian" lang="sq" hreflang="sq" data-title="Antibiotiku" data-language-autonym="Shqip" data-language-local-name="Albanian" class="interlanguage-link-target"><span>Shqip</span></a></li><li class="interlanguage-link interwiki-si mw-list-item"><a href="https://si.wikipedia.org/wiki/%E0%B6%B4%E0%B7%8A%E2%80%8D%E0%B6%BB%E0%B6%AD%E0%B7%92%E0%B6%A2%E0%B7%93%E0%B7%80%E0%B6%9A" title="ප්‍රතිජීවක – Sinhala" lang="si" hreflang="si" data-title="ප්‍රතිජීවක" data-language-autonym="සිංහල" data-language-local-name="Sinhala" class="interlanguage-link-target"><span>සිංහල</span></a></li><li class="interlanguage-link interwiki-simple mw-list-item"><a href="https://simple.wikipedia.org/wiki/Antibiotics" title="Antibiotics – Simple English" lang="en-simple" hreflang="en-simple" data-title="Antibiotics" data-language-autonym="Simple English" data-language-local-name="Simple English" class="interlanguage-link-target"><span>Simple English</span></a></li><li class="interlanguage-link interwiki-sk mw-list-item"><a href="https://sk.wikipedia.org/wiki/Antibiotikum" title="Antibiotikum – Slovak" lang="sk" hreflang="sk" data-title="Antibiotikum" data-language-autonym="Slovenčina" data-language-local-name="Slovak" class="interlanguage-link-target"><span>Slovenčina</span></a></li><li class="interlanguage-link interwiki-sl mw-list-item"><a href="https://sl.wikipedia.org/wiki/Antibiotik" title="Antibiotik – Slovenian" lang="sl" hreflang="sl" data-title="Antibiotik" data-language-autonym="Slovenščina" data-language-local-name="Slovenian" class="interlanguage-link-target"><span>Slovenščina</span></a></li><li class="interlanguage-link interwiki-ckb mw-list-item"><a href="https://ckb.wikipedia.org/wiki/%D8%AF%DA%98%DB%95%D8%B2%DB%8C%D9%86%D8%AF%DB%95%DB%8C%DB%8C" title="دژەزیندەیی – Central Kurdish" lang="ckb" hreflang="ckb" data-title="دژەزیندەیی" data-language-autonym="کوردی" data-language-local-name="Central Kurdish" class="interlanguage-link-target"><span>کوردی</span></a></li><li class="interlanguage-link interwiki-sr mw-list-item"><a href="https://sr.wikipedia.org/wiki/%D0%90%D0%BD%D1%82%D0%B8%D0%B1%D0%B8%D0%BE%D1%82%D0%B8%D0%BA" title="Антибиотик – Serbian" lang="sr" hreflang="sr" data-title="Антибиотик" data-language-autonym="Српски / srpski" data-language-local-name="Serbian" class="interlanguage-link-target"><span>Српски / srpski</span></a></li><li class="interlanguage-link interwiki-sh mw-list-item"><a href="https://sh.wikipedia.org/wiki/Antibiotici" title="Antibiotici – Serbo-Croatian" lang="sh" hreflang="sh" data-title="Antibiotici" data-language-autonym="Srpskohrvatski / српскохрватски" data-language-local-name="Serbo-Croatian" class="interlanguage-link-target"><span>Srpskohrvatski / српскохрватски</span></a></li><li class="interlanguage-link interwiki-fi mw-list-item"><a href="https://fi.wikipedia.org/wiki/Antibiootti" title="Antibiootti – Finnish" lang="fi" hreflang="fi" data-title="Antibiootti" data-language-autonym="Suomi" data-language-local-name="Finnish" class="interlanguage-link-target"><span>Suomi</span></a></li><li class="interlanguage-link interwiki-sv mw-list-item"><a href="https://sv.wikipedia.org/wiki/Antibiotikum" title="Antibiotikum – Swedish" lang="sv" hreflang="sv" data-title="Antibiotikum" data-language-autonym="Svenska" data-language-local-name="Swedish" class="interlanguage-link-target"><span>Svenska</span></a></li><li class="interlanguage-link interwiki-tl mw-list-item"><a href="https://tl.wikipedia.org/wiki/Antibiyotiko" title="Antibiyotiko – Tagalog" lang="tl" hreflang="tl" data-title="Antibiyotiko" data-language-autonym="Tagalog" data-language-local-name="Tagalog" class="interlanguage-link-target"><span>Tagalog</span></a></li><li class="interlanguage-link interwiki-ta mw-list-item"><a href="https://ta.wikipedia.org/wiki/%E0%AE%A8%E0%AF%81%E0%AE%A3%E0%AF%8D%E0%AE%A3%E0%AF%81%E0%AE%AF%E0%AE%BF%E0%AE%B0%E0%AF%8D_%E0%AE%8E%E0%AE%A4%E0%AE%BF%E0%AE%B0%E0%AF%8D%E0%AE%AA%E0%AF%8D%E0%AE%AA%E0%AE%BF" title="நுண்ணுயிர் எதிர்ப்பி – Tamil" lang="ta" hreflang="ta" data-title="நுண்ணுயிர் எதிர்ப்பி" data-language-autonym="தமிழ்" data-language-local-name="Tamil" class="interlanguage-link-target"><span>தமிழ்</span></a></li><li class="interlanguage-link interwiki-tt mw-list-item"><a href="https://tt.wikipedia.org/wiki/%D0%90%D0%BD%D1%82%D0%B8%D0%B1%D0%B8%D0%BE%D1%82%D0%B8%D0%BA%D0%BB%D0%B0%D1%80" title="Антибиотиклар – Tatar" lang="tt" hreflang="tt" data-title="Антибиотиклар" data-language-autonym="Татарча / tatarça" data-language-local-name="Tatar" class="interlanguage-link-target"><span>Татарча / tatarça</span></a></li><li class="interlanguage-link interwiki-te mw-list-item"><a href="https://te.wikipedia.org/wiki/%E0%B0%AF%E0%B0%BE%E0%B0%82%E0%B0%9F%E0%B1%80%E0%B0%AC%E0%B0%AF%E0%B1%8B%E0%B0%9F%E0%B0%BF%E0%B0%95%E0%B1%8D" title="యాంటీబయోటిక్ – Telugu" lang="te" hreflang="te" data-title="యాంటీబయోటిక్" data-language-autonym="తెలుగు" data-language-local-name="Telugu" class="interlanguage-link-target"><span>తెలుగు</span></a></li><li class="interlanguage-link interwiki-th mw-list-item"><a href="https://th.wikipedia.org/wiki/%E0%B8%A2%E0%B8%B2%E0%B8%9B%E0%B8%8F%E0%B8%B4%E0%B8%8A%E0%B8%B5%E0%B8%A7%E0%B8%99%E0%B8%B0" title="ยาปฏิชีวนะ – Thai" lang="th" hreflang="th" data-title="ยาปฏิชีวนะ" data-language-autonym="ไทย" data-language-local-name="Thai" class="interlanguage-link-target"><span>ไทย</span></a></li><li class="interlanguage-link interwiki-tg mw-list-item"><a href="https://tg.wikipedia.org/wiki/%D0%9F%D0%BE%D0%B4%D0%B7%D0%B8%D1%81%D1%82" title="Подзист – Tajik" lang="tg" hreflang="tg" data-title="Подзист" data-language-autonym="Тоҷикӣ" data-language-local-name="Tajik" class="interlanguage-link-target"><span>Тоҷикӣ</span></a></li><li class="interlanguage-link interwiki-tr mw-list-item"><a href="https://tr.wikipedia.org/wiki/Antibiyotik" title="Antibiyotik – Turkish" lang="tr" hreflang="tr" data-title="Antibiyotik" data-language-autonym="Türkçe" data-language-local-name="Turkish" class="interlanguage-link-target"><span>Türkçe</span></a></li><li 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id="mw-content-text" class="mw-body-content"><div class="mw-content-ltr mw-parser-output" lang="en" dir="ltr"><div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Antimicrobial substance active against bacteria</div> <style data-mw-deduplicate="TemplateStyles:r1236090951">.mw-parser-output .hatnote{font-style:italic}.mw-parser-output div.hatnote{padding-left:1.6em;margin-bottom:0.5em}.mw-parser-output .hatnote i{font-style:normal}.mw-parser-output .hatnote+link+.hatnote{margin-top:-0.5em}@media print{body.ns-0 .mw-parser-output .hatnote{display:none!important}}</style><div role="note" class="hatnote navigation-not-searchable">"Antibacterial" redirects here. For other uses, see <a href="/wiki/Antibacterial_(disambiguation)" class="mw-disambig" title="Antibacterial (disambiguation)">Antibacterial (disambiguation)</a>.</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">This article is about treatment of bacterial infection. For anti-tumor antibiotics, see <a href="/wiki/Chemotherapy#Cytotoxic_antibiotics" title="Chemotherapy">Chemotherapy §&#160;Cytotoxic antibiotics</a>.</div> <p class="mw-empty-elt"> </p> <style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox"><tbody><tr><th colspan="2" class="infobox-above" style="background-color: #ddbbee">Antibiotic</th></tr><tr><td colspan="2" class="infobox-subheader"><i><a href="/wiki/Drug_class" title="Drug class">Drug class</a></i></td></tr><tr><td colspan="2" class="infobox-image"><span class="mw-default-size" typeof="mw:File/Frameless"><a href="/wiki/File:Staphylococcus_aureus_(AB_Test).jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/5/59/Staphylococcus_aureus_%28AB_Test%29.jpg/280px-Staphylococcus_aureus_%28AB_Test%29.jpg" decoding="async" width="280" height="254" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/5/59/Staphylococcus_aureus_%28AB_Test%29.jpg/420px-Staphylococcus_aureus_%28AB_Test%29.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/5/59/Staphylococcus_aureus_%28AB_Test%29.jpg/560px-Staphylococcus_aureus_%28AB_Test%29.jpg 2x" data-file-width="2315" data-file-height="2097" /></a></span><div class="infobox-caption">Testing the susceptibility of <i><a href="/wiki/Staphylococcus_aureus" title="Staphylococcus aureus">Staphylococcus aureus</a></i> to antibiotics by the <a href="/wiki/Kirby-Bauer_antibiotic_testing" class="mw-redirect" title="Kirby-Bauer antibiotic testing">Kirby-Bauer disk diffusion method</a> – antibiotics diffuse from antibiotic-containing disks and inhibit growth of <i>S. aureus</i>, resulting in a zone of inhibition.</div></td></tr><tr><th colspan="2" class="infobox-header" style="background: #e8e8e8;">Legal status</th></tr><tr><td colspan="2" class="infobox-below" style="background: #e8e8e8; text-align: center"><a href="https://www.wikidata.org/wiki/Q12187" class="extiw" title="d:Q12187">In Wikidata</a></td></tr></tbody></table> <p>An <b>antibiotic</b> is a type of <a href="/wiki/Antimicrobial" title="Antimicrobial">antimicrobial</a> substance active against <a href="/wiki/Bacteria" title="Bacteria">bacteria</a>. It is the most important type of antibacterial agent for fighting <a href="/wiki/Pathogenic_bacteria" title="Pathogenic bacteria">bacterial infections</a>, and antibiotic <a href="/wiki/Medication" title="Medication">medications</a> are widely used in the <a href="/wiki/Therapy" title="Therapy">treatment</a> and <a href="/wiki/Antibiotic_prophylaxis" title="Antibiotic prophylaxis">prevention</a> of such infections.<sup id="cite_ref-NHSB_1-0" class="reference"><a href="#cite_note-NHSB-1"><span class="cite-bracket">&#91;</span>1<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-2" class="reference"><a href="#cite_note-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup> They may either <a href="/wiki/Bactericide" title="Bactericide">kill</a> or <a href="/wiki/Bacteriostatic_agent" title="Bacteriostatic agent">inhibit the growth</a> of bacteria. A limited number of antibiotics also possess <a href="/wiki/Antiprotozoal" title="Antiprotozoal">antiprotozoal</a> activity.<sup id="cite_ref-3" class="reference"><a href="#cite_note-3"><span class="cite-bracket">&#91;</span>3<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-Antibioticandantiprotozal_4-0" class="reference"><a href="#cite_note-Antibioticandantiprotozal-4"><span class="cite-bracket">&#91;</span>4<span class="cite-bracket">&#93;</span></a></sup> Antibiotics are not effective against <a href="/wiki/Virus" title="Virus">viruses</a> such as the ones which cause the <a href="/wiki/Common_cold" title="Common cold">common cold</a> or <a href="/wiki/Influenza" title="Influenza">influenza</a>.<sup id="cite_ref-5" class="reference"><a href="#cite_note-5"><span class="cite-bracket">&#91;</span>5<span class="cite-bracket">&#93;</span></a></sup> Drugs which inhibit growth of viruses are termed <a href="/wiki/Antiviral_drug" title="Antiviral drug">antiviral drugs</a> or antivirals. Antibiotics are also not effective against <a href="/wiki/Fungi" class="mw-redirect" title="Fungi">fungi</a>. Drugs which inhibit growth of fungi are called <a href="/wiki/Antifungal_drug" class="mw-redirect" title="Antifungal drug">antifungal drugs</a>. </p><p>Sometimes, the term <i>antibiotic</i>—literally "opposing life", from the <a href="/wiki/Greek_language" title="Greek language">Greek</a> roots ἀντι <i>anti</i>, "against" and βίος <i>bios</i>, "life"—is broadly used to refer to any substance used against <a href="/wiki/Microbe" class="mw-redirect" title="Microbe">microbes</a>, but in the usual medical usage, antibiotics (such as <a href="/wiki/Penicillin" title="Penicillin">penicillin</a>) are those produced naturally (by one <a href="/wiki/Microorganism" title="Microorganism">microorganism</a> fighting another), whereas non-antibiotic antibacterials (such as <a href="/wiki/Sulfonamide" title="Sulfonamide">sulfonamides</a> and <a href="/wiki/Antiseptic" title="Antiseptic">antiseptics</a>) are <a href="/wiki/Total_synthesis" title="Total synthesis">fully synthetic</a>. However, both classes have the same effect of killing or preventing the growth of microorganisms, and both are included in <a href="/wiki/Antimicrobial_chemotherapy" title="Antimicrobial chemotherapy">antimicrobial chemotherapy</a>. "Antibacterials" include <a href="/wiki/Bactericide" title="Bactericide">bactericides</a>, <a href="/wiki/Bacteriostatic" class="mw-redirect" title="Bacteriostatic">bacteriostatics</a>, <a href="/wiki/Antibacterial_soap" title="Antibacterial soap">antibacterial soaps</a>, and chemical <a href="/wiki/Disinfectant" title="Disinfectant">disinfectants</a>, whereas antibiotics are an important class of antibacterials used more specifically in medicine<sup id="cite_ref-6" class="reference"><a href="#cite_note-6"><span class="cite-bracket">&#91;</span>6<span class="cite-bracket">&#93;</span></a></sup> and <a href="/wiki/Antibiotic_use_in_livestock" title="Antibiotic use in livestock">sometimes in livestock feed</a>. </p><p>Antibiotics have been used since ancient times. Many civilizations used topical application of moldy bread, with many references to its beneficial effects arising from ancient Egypt, <a href="/wiki/Nubia" title="Nubia">Nubia</a>, <a href="/wiki/China" title="China">China</a>, <a href="/wiki/Serbia" title="Serbia">Serbia</a>, Greece, and Rome.<sup id="cite_ref-7" class="reference"><a href="#cite_note-7"><span class="cite-bracket">&#91;</span>7<span class="cite-bracket">&#93;</span></a></sup> The first person to directly document the use of molds to treat infections was <a href="/wiki/John_Parkinson_(botanist)" title="John Parkinson (botanist)">John Parkinson</a> (1567–1650). Antibiotics revolutionized medicine in the 20th century. Synthetic antibiotic chemotherapy as a science and development of antibacterials began in Germany with <a href="/wiki/Paul_Ehrlich" title="Paul Ehrlich">Paul Ehrlich</a> in the late 1880s.<sup id="cite_ref-CALDERIN2007_8-0" class="reference"><a href="#cite_note-CALDERIN2007-8"><span class="cite-bracket">&#91;</span>8<span class="cite-bracket">&#93;</span></a></sup> <a href="/wiki/Alexander_Fleming" title="Alexander Fleming">Alexander Fleming</a> (1881–1955) discovered modern day <a href="/wiki/Penicillin" title="Penicillin">penicillin</a> in 1928, the widespread use of which proved significantly beneficial during wartime. The first <a href="/wiki/Sulfonamide_(medicine)" title="Sulfonamide (medicine)">sulfonamide</a> and the first <a href="https://en.wiktionary.org/wiki/systemic" class="extiw" title="wikt:systemic">systemically</a> active antibacterial drug, <a href="/wiki/Prontosil" title="Prontosil">Prontosil</a>, was developed by a research team led by <a href="/wiki/Gerhard_Domagk" title="Gerhard Domagk">Gerhard Domagk</a> in 1932 or 1933 at the <a href="/wiki/Bayer" title="Bayer">Bayer</a> Laboratories of the <a href="/wiki/IG_Farben" title="IG Farben">IG Farben</a> conglomerate in Germany.<sup id="cite_ref-goodman_9-0" class="reference"><a href="#cite_note-goodman-9"><span class="cite-bracket">&#91;</span>9<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-ReferenceA_10-0" class="reference"><a href="#cite_note-ReferenceA-10"><span class="cite-bracket">&#91;</span>10<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-Bosch2008_11-0" class="reference"><a href="#cite_note-Bosch2008-11"><span class="cite-bracket">&#91;</span>11<span class="cite-bracket">&#93;</span></a></sup> However, the effectiveness and easy access to antibiotics have also led to their <a href="/wiki/Antibiotic_misuse" title="Antibiotic misuse">overuse</a><sup id="cite_ref-12" class="reference"><a href="#cite_note-12"><span class="cite-bracket">&#91;</span>12<span class="cite-bracket">&#93;</span></a></sup> and some bacteria have evolved <a href="/wiki/Antibiotic_resistance" class="mw-redirect" title="Antibiotic resistance">resistance</a> to them.<sup id="cite_ref-NHSB_1-1" class="reference"><a href="#cite_note-NHSB-1"><span class="cite-bracket">&#91;</span>1<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-13" class="reference"><a href="#cite_note-13"><span class="cite-bracket">&#91;</span>13<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-14" class="reference"><a href="#cite_note-14"><span class="cite-bracket">&#91;</span>14<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-15" class="reference"><a href="#cite_note-15"><span class="cite-bracket">&#91;</span>15<span class="cite-bracket">&#93;</span></a></sup> <a href="/wiki/Antimicrobial_resistance" title="Antimicrobial resistance">Antimicrobial resistance</a> (AMR), a naturally occurring process, is driven largely by the misuse and overuse of antimicrobials.<sup id="cite_ref-CDC_About_Antimicrobial_Resistance_16-0" class="reference"><a href="#cite_note-CDC_About_Antimicrobial_Resistance-16"><span class="cite-bracket">&#91;</span>16<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-WHO10October2024_17-0" class="reference"><a href="#cite_note-WHO10October2024-17"><span class="cite-bracket">&#91;</span>17<span class="cite-bracket">&#93;</span></a></sup> Yet, at the same time, many people around the world do not have access to essential antimicrobials.<sup id="cite_ref-WHO10October2024_17-1" class="reference"><a href="#cite_note-WHO10October2024-17"><span class="cite-bracket">&#91;</span>17<span class="cite-bracket">&#93;</span></a></sup> The <a href="/wiki/World_Health_Organization" title="World Health Organization">World Health Organization</a> has classified AMR as a widespread "serious threat [that] is no longer a prediction for the future, it is happening right now in every region of the world and has the potential to affect anyone, of any age, in any country".<sup id="cite_ref-WHO2014_18-0" class="reference"><a href="#cite_note-WHO2014-18"><span class="cite-bracket">&#91;</span>18<span class="cite-bracket">&#93;</span></a></sup> Each year, nearly 5 million deaths are associated with AMR globally.<sup id="cite_ref-WHO10October2024_17-2" class="reference"><a href="#cite_note-WHO10October2024-17"><span class="cite-bracket">&#91;</span>17<span class="cite-bracket">&#93;</span></a></sup> Global deaths attributable to AMR numbered 1.27 million in 2019.<sup id="cite_ref-19" class="reference"><a href="#cite_note-19"><span class="cite-bracket">&#91;</span>19<span class="cite-bracket">&#93;</span></a></sup> </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Etymology">Etymology</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Antibiotic&amp;action=edit&amp;section=1" title="Edit section: Etymology"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The term 'antibiosis', meaning "against life", was introduced by the French bacteriologist <a href="/wiki/Jean_Paul_Vuillemin" title="Jean Paul Vuillemin">Jean Paul Vuillemin</a> as a descriptive name of the phenomenon exhibited by these early antibacterial drugs.<sup id="cite_ref-CALDERIN2007_8-1" class="reference"><a href="#cite_note-CALDERIN2007-8"><span class="cite-bracket">&#91;</span>8<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-Saxena_20-0" class="reference"><a href="#cite_note-Saxena-20"><span class="cite-bracket">&#91;</span>20<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-21" class="reference"><a href="#cite_note-21"><span class="cite-bracket">&#91;</span>21<span class="cite-bracket">&#93;</span></a></sup> Antibiosis was first described in 1877 in bacteria when <a href="/wiki/Louis_Pasteur" title="Louis Pasteur">Louis Pasteur</a> and <a href="/wiki/Robert_Koch" title="Robert Koch">Robert Koch</a> observed that an airborne bacillus could inhibit the growth of <i><a href="/wiki/Bacillus_anthracis" title="Bacillus anthracis">Bacillus anthracis</a></i>.<sup id="cite_ref-Saxena_20-1" class="reference"><a href="#cite_note-Saxena-20"><span class="cite-bracket">&#91;</span>20<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-22" class="reference"><a href="#cite_note-22"><span class="cite-bracket">&#91;</span>22<span class="cite-bracket">&#93;</span></a></sup> These drugs were later renamed antibiotics by <a href="/wiki/Selman_Waksman" title="Selman Waksman">Selman Waksman</a>, an American microbiologist, in 1947.<sup id="cite_ref-23" class="reference"><a href="#cite_note-23"><span class="cite-bracket">&#91;</span>23<span class="cite-bracket">&#93;</span></a></sup> </p><p>The term <i>antibiotic</i> was first used in 1942 by <a href="/wiki/Selman_Waksman" title="Selman Waksman">Selman Waksman</a> and his collaborators in journal articles to describe any substance produced by a microorganism that is <a href="https://en.wiktionary.org/wiki/antagonism" class="extiw" title="wikt:antagonism">antagonistic</a> to the growth of other microorganisms in high dilution.<sup id="cite_ref-Saxena_20-2" class="reference"><a href="#cite_note-Saxena-20"><span class="cite-bracket">&#91;</span>20<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-Wakeman1947_24-0" class="reference"><a href="#cite_note-Wakeman1947-24"><span class="cite-bracket">&#91;</span>24<span class="cite-bracket">&#93;</span></a></sup> This definition excluded substances that kill bacteria but that are not produced by microorganisms (such as <a href="/wiki/Gastric_juices" class="mw-redirect" title="Gastric juices">gastric juices</a> and <a href="/wiki/Hydrogen_peroxide" title="Hydrogen peroxide">hydrogen peroxide</a>). It also excluded <a href="/wiki/Chemical_synthesis" title="Chemical synthesis">synthetic</a> antibacterial compounds such as the <a href="/wiki/Sulfonamide_(medicine)" title="Sulfonamide (medicine)">sulfonamides</a>. In current usage, the term "antibiotic" is applied to any medication that kills bacteria or inhibits their growth, regardless of whether that medication is produced by a microorganism or not.<sup id="cite_ref-25" class="reference"><a href="#cite_note-25"><span class="cite-bracket">&#91;</span>25<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-26" class="reference"><a href="#cite_note-26"><span class="cite-bracket">&#91;</span>26<span class="cite-bracket">&#93;</span></a></sup> </p><p>The term "antibiotic" derives from <i>anti</i> + βιωτικός (<i>biōtikos</i>), "fit for life, lively",<sup id="cite_ref-27" class="reference"><a href="#cite_note-27"><span class="cite-bracket">&#91;</span>27<span class="cite-bracket">&#93;</span></a></sup> which comes from βίωσις (<i>biōsis</i>), "way of life",<sup id="cite_ref-28" class="reference"><a href="#cite_note-28"><span class="cite-bracket">&#91;</span>28<span class="cite-bracket">&#93;</span></a></sup> and that from βίος (<i>bios</i>), "life".<sup id="cite_ref-Antibiotics_FAQ_29-0" class="reference"><a href="#cite_note-Antibiotics_FAQ-29"><span class="cite-bracket">&#91;</span>29<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-30" class="reference"><a href="#cite_note-30"><span class="cite-bracket">&#91;</span>30<span class="cite-bracket">&#93;</span></a></sup> The term "antibacterial" derives from <a href="/wiki/Greek_language" title="Greek language">Greek</a> ἀντί (<i>anti</i>), "against"<sup id="cite_ref-31" class="reference"><a href="#cite_note-31"><span class="cite-bracket">&#91;</span>31<span class="cite-bracket">&#93;</span></a></sup> + βακτήριον (<i>baktērion</i>), diminutive of βακτηρία (<i>baktēria</i>), "staff, cane",<sup id="cite_ref-32" class="reference"><a href="#cite_note-32"><span class="cite-bracket">&#91;</span>32<span class="cite-bracket">&#93;</span></a></sup> because the first bacteria to be discovered were rod-shaped.<sup id="cite_ref-33" class="reference"><a href="#cite_note-33"><span class="cite-bracket">&#91;</span>33<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Usage">Usage</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Antibiotic&amp;action=edit&amp;section=2" title="Edit section: Usage"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading3"><h3 id="Medical_uses">Medical uses</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Antibiotic&amp;action=edit&amp;section=3" title="Edit section: Medical uses"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Antibiotics are used to treat or prevent bacterial infections,<sup id="cite_ref-Antibiotic_34-0" class="reference"><a href="#cite_note-Antibiotic-34"><span class="cite-bracket">&#91;</span>34<span class="cite-bracket">&#93;</span></a></sup> and sometimes <a href="/wiki/Protozoan_infection" title="Protozoan infection">protozoan infections</a>. (<a href="/wiki/Metronidazole" title="Metronidazole">Metronidazole</a> is effective against a number of <a href="/wiki/Parasitic_disease" title="Parasitic disease">parasitic diseases</a>). When an infection is suspected of being responsible for an illness but the responsible pathogen has not been identified, an <a href="/wiki/Empiric_therapy" title="Empiric therapy">empiric therapy</a> is adopted.<sup id="cite_ref-General_principles_35-0" class="reference"><a href="#cite_note-General_principles-35"><span class="cite-bracket">&#91;</span>35<span class="cite-bracket">&#93;</span></a></sup> This involves the administration of a <a href="/wiki/Broad-spectrum_antibiotic" title="Broad-spectrum antibiotic">broad-spectrum antibiotic</a> based on the signs and symptoms presented and is initiated pending laboratory results that can take several days.<sup id="cite_ref-Antibiotic_34-1" class="reference"><a href="#cite_note-Antibiotic-34"><span class="cite-bracket">&#91;</span>34<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-General_principles_35-1" class="reference"><a href="#cite_note-General_principles-35"><span class="cite-bracket">&#91;</span>35<span class="cite-bracket">&#93;</span></a></sup> </p><p>When the responsible pathogenic microorganism is already known or has been identified, <a href="/wiki/Therapy#Definitive_therapy" title="Therapy">definitive therapy</a> can be started. This will usually involve the use of a narrow-spectrum antibiotic. The choice of antibiotic given will also be based on its cost. Identification is critically important as it can reduce the cost and toxicity of the antibiotic therapy and also reduce the possibility of the emergence of antimicrobial resistance.<sup id="cite_ref-General_principles_35-2" class="reference"><a href="#cite_note-General_principles-35"><span class="cite-bracket">&#91;</span>35<span class="cite-bracket">&#93;</span></a></sup> To avoid surgery, antibiotics may be given for non-complicated acute <a href="/wiki/Appendicitis" title="Appendicitis">appendicitis</a>.<sup id="cite_ref-36" class="reference"><a href="#cite_note-36"><span class="cite-bracket">&#91;</span>36<span class="cite-bracket">&#93;</span></a></sup> </p><p>Antibiotics may be given as a <a href="/wiki/Preventive_healthcare" title="Preventive healthcare">preventive measure</a> and this is usually limited to at-risk populations such as those with a <a href="/wiki/Immunodeficiency" title="Immunodeficiency">weakened immune system</a> (particularly in <a href="/wiki/HIV" title="HIV">HIV</a> cases to prevent <a href="/wiki/Pneumonia" title="Pneumonia">pneumonia</a>), those taking <a href="/wiki/Immunosuppressive_drug" title="Immunosuppressive drug">immunosuppressive drugs</a>, <a href="/wiki/Cancer" title="Cancer">cancer</a> patients, and those having <a href="/wiki/Surgery" title="Surgery">surgery</a>.<sup id="cite_ref-Antibiotic_34-2" class="reference"><a href="#cite_note-Antibiotic-34"><span class="cite-bracket">&#91;</span>34<span class="cite-bracket">&#93;</span></a></sup> Their use in surgical procedures is to help prevent infection of <a href="/wiki/Surgical_incision" title="Surgical incision">incisions</a>. They have an important role in <a href="/wiki/Dental_antibiotic_prophylaxis" title="Dental antibiotic prophylaxis">dental antibiotic prophylaxis</a> where their use may prevent <a href="/wiki/Bacteremia" class="mw-redirect" title="Bacteremia">bacteremia</a> and consequent <a href="/wiki/Infective_endocarditis" title="Infective endocarditis">infective endocarditis</a>. Antibiotics are also used to prevent infection in cases of <a href="/wiki/Neutropenia" title="Neutropenia">neutropenia</a> particularly cancer-related.<sup id="cite_ref-37" class="reference"><a href="#cite_note-37"><span class="cite-bracket">&#91;</span>37<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-38" class="reference"><a href="#cite_note-38"><span class="cite-bracket">&#91;</span>38<span class="cite-bracket">&#93;</span></a></sup> </p><p>The use of antibiotics for secondary prevention of coronary heart disease is not supported by current scientific evidence, and may actually increase cardiovascular mortality, all-cause mortality and the occurrence of stroke.<sup id="cite_ref-:4_39-0" class="reference"><a href="#cite_note-:4-39"><span class="cite-bracket">&#91;</span>39<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Routes_of_administration">Routes of administration</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Antibiotic&amp;action=edit&amp;section=4" title="Edit section: Routes of administration"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>There are many different <a href="/wiki/Routes_of_administration" class="mw-redirect" title="Routes of administration">routes of administration</a> for antibiotic treatment. Antibiotics are usually <a href="/wiki/Oral_administration" title="Oral administration">taken by mouth</a>. In more severe cases, particularly deep-seated <a href="/wiki/Systemic_disease" title="Systemic disease">systemic infections</a>, antibiotics can be given <a href="/wiki/Intravenous_therapy" title="Intravenous therapy">intravenously</a> or by injection.<sup id="cite_ref-NHSB_1-2" class="reference"><a href="#cite_note-NHSB-1"><span class="cite-bracket">&#91;</span>1<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-General_principles_35-3" class="reference"><a href="#cite_note-General_principles-35"><span class="cite-bracket">&#91;</span>35<span class="cite-bracket">&#93;</span></a></sup> Where the site of infection is easily accessed, antibiotics may be given <a href="/wiki/Routes_of_administration#Topical" class="mw-redirect" title="Routes of administration">topically</a> in the form of <a href="/wiki/Eye_drop" title="Eye drop">eye drops</a> onto the <a href="/wiki/Conjunctiva" title="Conjunctiva">conjunctiva</a> for <a href="/wiki/Conjunctivitis" title="Conjunctivitis">conjunctivitis</a> or <a href="/wiki/Ear_drop" title="Ear drop">ear drops</a> for ear infections and acute cases of <a href="/wiki/Otitis_externa" title="Otitis externa">swimmer's ear</a>. Topical use is also one of the treatment options for some skin conditions including <a href="/wiki/Acne_vulgaris" class="mw-redirect" title="Acne vulgaris">acne</a> and <a href="/wiki/Cellulitis" title="Cellulitis">cellulitis</a>.<sup id="cite_ref-40" class="reference"><a href="#cite_note-40"><span class="cite-bracket">&#91;</span>40<span class="cite-bracket">&#93;</span></a></sup> Advantages of topical application include achieving high and sustained concentration of antibiotic at the site of infection; reducing the potential for systemic absorption and toxicity, and total volumes of antibiotic required are reduced, thereby also reducing the risk of antibiotic misuse.<sup id="cite_ref-Treating_chronic_wounds_41-0" class="reference"><a href="#cite_note-Treating_chronic_wounds-41"><span class="cite-bracket">&#91;</span>41<span class="cite-bracket">&#93;</span></a></sup> Topical antibiotics applied over certain types of surgical wounds have been reported to reduce the risk of surgical site infections.<sup id="cite_ref-42" class="reference"><a href="#cite_note-42"><span class="cite-bracket">&#91;</span>42<span class="cite-bracket">&#93;</span></a></sup> However, there are certain general causes for concern with topical administration of antibiotics. Some systemic absorption of the antibiotic may occur; the quantity of antibiotic applied is difficult to accurately dose, and there is also the possibility of local <a href="/wiki/Hypersensitivity" title="Hypersensitivity">hypersensitivity</a> reactions or <a href="/wiki/Contact_dermatitis" title="Contact dermatitis">contact dermatitis</a> occurring.<sup id="cite_ref-Treating_chronic_wounds_41-1" class="reference"><a href="#cite_note-Treating_chronic_wounds-41"><span class="cite-bracket">&#91;</span>41<span class="cite-bracket">&#93;</span></a></sup> It is recommended to administer antibiotics as soon as possible, especially in life-threatening infections. Many emergency departments stock antibiotics for this purpose.<sup id="cite_ref-43" class="reference"><a href="#cite_note-43"><span class="cite-bracket">&#91;</span>43<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Global_consumption">Global consumption</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Antibiotic&amp;action=edit&amp;section=5" title="Edit section: Global consumption"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Antibiotic consumption varies widely between countries. The <a href="/wiki/WHO" class="mw-redirect" title="WHO">WHO</a> report on surveillance of antibiotic consumption published in 2018 analysed 2015 data from 65 countries. As measured in defined daily doses per 1,000 inhabitants per day. Mongolia had the highest consumption with a rate of 64.4. Burundi had the lowest at 4.4. <a href="/wiki/Amoxicillin" title="Amoxicillin">Amoxicillin</a> and <a href="/wiki/Amoxicillin/clavulanic_acid" title="Amoxicillin/clavulanic acid">amoxicillin/clavulanic acid</a> were the most frequently consumed.<sup id="cite_ref-44" class="reference"><a href="#cite_note-44"><span class="cite-bracket">&#91;</span>44<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Side_effects">Side effects</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Antibiotic&amp;action=edit&amp;section=6" title="Edit section: Side effects"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size mw-halign-right" typeof="mw:File/Thumb"><a href="/wiki/File:Choosing_Wisely_antibiotics_poster_small_English.pdf" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/0/00/Choosing_Wisely_antibiotics_poster_small_English.pdf/page1-220px-Choosing_Wisely_antibiotics_poster_small_English.pdf.jpg" decoding="async" width="220" height="285" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/0/00/Choosing_Wisely_antibiotics_poster_small_English.pdf/page1-330px-Choosing_Wisely_antibiotics_poster_small_English.pdf.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/0/00/Choosing_Wisely_antibiotics_poster_small_English.pdf/page1-440px-Choosing_Wisely_antibiotics_poster_small_English.pdf.jpg 2x" data-file-width="1275" data-file-height="1650" /></a><figcaption>Health advocacy messages such as this one encourage patients to talk with their doctor about safety in using antibiotics.</figcaption></figure> <p>Antibiotics are screened for any negative effects before their approval for clinical use, and are usually considered safe and well tolerated. However, some antibiotics have been associated with a wide extent of adverse <a href="/wiki/Side_effect" title="Side effect">side effects</a> ranging from mild to very severe depending on the type of antibiotic used, the microbes targeted, and the individual patient.<sup id="cite_ref-pmid15993671_45-0" class="reference"><a href="#cite_note-pmid15993671-45"><span class="cite-bracket">&#91;</span>45<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-46" class="reference"><a href="#cite_note-46"><span class="cite-bracket">&#91;</span>46<span class="cite-bracket">&#93;</span></a></sup> Side effects may reflect the pharmacological or toxicological properties of the antibiotic or may involve hypersensitivity or <a href="/wiki/Allergy" title="Allergy">allergic</a> reactions.<sup id="cite_ref-Antibioticandantiprotozal_4-1" class="reference"><a href="#cite_note-Antibioticandantiprotozal-4"><span class="cite-bracket">&#91;</span>4<span class="cite-bracket">&#93;</span></a></sup> Adverse effects range from fever and nausea to major allergic reactions, including <a href="/wiki/Photodermatitis" title="Photodermatitis">photodermatitis</a> and <a href="/wiki/Anaphylaxis" title="Anaphylaxis">anaphylaxis</a>.<sup id="cite_ref-47" class="reference"><a href="#cite_note-47"><span class="cite-bracket">&#91;</span>47<span class="cite-bracket">&#93;</span></a></sup> </p><p>Common side effects of oral antibiotics include <a href="/wiki/Diarrhea" title="Diarrhea">diarrhea</a>, resulting from disruption of the species composition in the <a href="/wiki/Intestinal_flora" class="mw-redirect" title="Intestinal flora">intestinal flora</a>, resulting, for example, in overgrowth of pathogenic bacteria, such as <i><a href="/wiki/Clostridioides_difficile_(bacteria)" class="mw-redirect" title="Clostridioides difficile (bacteria)">Clostridioides difficile</a></i>.<sup id="cite_ref-48" class="reference"><a href="#cite_note-48"><span class="cite-bracket">&#91;</span>48<span class="cite-bracket">&#93;</span></a></sup> Taking <a href="/wiki/Probiotics" class="mw-redirect" title="Probiotics">probiotics</a> during the course of antibiotic treatment can help prevent antibiotic-associated diarrhea.<sup id="cite_ref-49" class="reference"><a href="#cite_note-49"><span class="cite-bracket">&#91;</span>49<span class="cite-bracket">&#93;</span></a></sup> Antibacterials can also affect the <a href="/wiki/Vaginal_flora" title="Vaginal flora">vaginal flora</a>, and may lead to overgrowth of <a href="/wiki/Yeast" title="Yeast">yeast</a> species of the genus <i><a href="/wiki/Candida_(genus)" class="mw-redirect" title="Candida (genus)">Candida</a></i> in the vulvo-vaginal area.<sup id="cite_ref-Pirotta_and_Garland_50-0" class="reference"><a href="#cite_note-Pirotta_and_Garland-50"><span class="cite-bracket">&#91;</span>50<span class="cite-bracket">&#93;</span></a></sup> Additional side effects can result from <a href="/wiki/Drug_interaction" title="Drug interaction">interaction</a> with other drugs, such as the possibility of <a href="/wiki/Tendon" title="Tendon">tendon</a> damage from the administration of a <a href="/wiki/Quinolone_antibiotic" title="Quinolone antibiotic">quinolone antibiotic</a> with a systemic <a href="/wiki/Corticosteroid" title="Corticosteroid">corticosteroid</a>.<sup id="cite_ref-51" class="reference"><a href="#cite_note-51"><span class="cite-bracket">&#91;</span>51<span class="cite-bracket">&#93;</span></a></sup> </p><p>Some antibiotics may also damage the <a href="/wiki/Mitochondrion" title="Mitochondrion">mitochondrion</a>, a bacteria-derived organelle found in eukaryotic, including human, cells.<sup id="cite_ref-52" class="reference"><a href="#cite_note-52"><span class="cite-bracket">&#91;</span>52<span class="cite-bracket">&#93;</span></a></sup> Mitochondrial damage cause <a href="/wiki/Oxidative_stress" title="Oxidative stress">oxidative stress</a> in cells and has been suggested as a mechanism for side effects from <a href="/wiki/Fluoroquinolone" class="mw-redirect" title="Fluoroquinolone">fluoroquinolones</a>.<sup id="cite_ref-53" class="reference"><a href="#cite_note-53"><span class="cite-bracket">&#91;</span>53<span class="cite-bracket">&#93;</span></a></sup> They are also known to affect <a href="/wiki/Chloroplast" title="Chloroplast">chloroplasts</a>.<sup id="cite_ref-54" class="reference"><a href="#cite_note-54"><span class="cite-bracket">&#91;</span>54<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Interactions">Interactions</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Antibiotic&amp;action=edit&amp;section=7" title="Edit section: Interactions"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading3"><h3 id="Birth_control_pills">Birth control pills</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Antibiotic&amp;action=edit&amp;section=8" title="Edit section: Birth control pills"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>There are few well-controlled studies on whether antibiotic use increases the risk of <a href="/wiki/Oral_contraceptive_pill" title="Oral contraceptive pill">oral contraceptive</a> failure.<sup id="cite_ref-OC_effectiveness_55-0" class="reference"><a href="#cite_note-OC_effectiveness-55"><span class="cite-bracket">&#91;</span>55<span class="cite-bracket">&#93;</span></a></sup> The majority of studies indicate antibiotics do not interfere with <a href="/wiki/Combined_oral_contraceptive_pill" title="Combined oral contraceptive pill">birth control pills</a>,<sup id="cite_ref-Weaver1999_56-0" class="reference"><a href="#cite_note-Weaver1999-56"><span class="cite-bracket">&#91;</span>56<span class="cite-bracket">&#93;</span></a></sup> such as clinical studies that suggest the failure rate of contraceptive pills caused by antibiotics is very low (about 1%).<sup id="cite_ref-pmid10384856_57-0" class="reference"><a href="#cite_note-pmid10384856-57"><span class="cite-bracket">&#91;</span>57<span class="cite-bracket">&#93;</span></a></sup> Situations that may increase the risk of oral contraceptive failure include <a href="/wiki/Compliance_(medicine)" class="mw-redirect" title="Compliance (medicine)">non-compliance</a> (missing taking the pill), vomiting, or diarrhea. Gastrointestinal disorders or interpatient variability in oral contraceptive absorption affecting <a href="/wiki/Ethinylestradiol" title="Ethinylestradiol">ethinylestradiol</a> <a href="/wiki/Serum_(blood)" title="Serum (blood)">serum levels</a> in the blood.<sup id="cite_ref-OC_effectiveness_55-1" class="reference"><a href="#cite_note-OC_effectiveness-55"><span class="cite-bracket">&#91;</span>55<span class="cite-bracket">&#93;</span></a></sup> Women with <a href="/wiki/Irregular_menstruation" title="Irregular menstruation">menstrual irregularities</a> may be at higher risk of failure and should be advised to use <a href="/wiki/Contraception" class="mw-redirect" title="Contraception">backup contraception</a> during antibiotic treatment and for one week after its completion. If patient-specific risk factors for reduced oral contraceptive efficacy are suspected, backup contraception is recommended.<sup id="cite_ref-OC_effectiveness_55-2" class="reference"><a href="#cite_note-OC_effectiveness-55"><span class="cite-bracket">&#91;</span>55<span class="cite-bracket">&#93;</span></a></sup> </p><p>In cases where antibiotics have been suggested to affect the efficiency of birth control pills, such as for the broad-spectrum antibiotic <a href="/wiki/Rifampicin" title="Rifampicin">rifampicin</a>, these cases may be due to an increase in the activities of hepatic liver enzymes' causing increased breakdown of the pill's active ingredients.<sup id="cite_ref-Weaver1999_56-1" class="reference"><a href="#cite_note-Weaver1999-56"><span class="cite-bracket">&#91;</span>56<span class="cite-bracket">&#93;</span></a></sup> Effects on the <a href="/wiki/Gut_flora" class="mw-redirect" title="Gut flora">intestinal flora</a>, which might result in reduced absorption of <a href="/wiki/Estrogen" title="Estrogen">estrogens</a> in the colon, have also been suggested, but such suggestions have been inconclusive and controversial.<sup id="cite_ref-pmid3155374_58-0" class="reference"><a href="#cite_note-pmid3155374-58"><span class="cite-bracket">&#91;</span>58<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-pmid2256523_59-0" class="reference"><a href="#cite_note-pmid2256523-59"><span class="cite-bracket">&#91;</span>59<span class="cite-bracket">&#93;</span></a></sup> Clinicians have recommended that extra contraceptive measures be applied during therapies using antibiotics that are suspected to interact with oral <a href="/wiki/Contraceptive" class="mw-redirect" title="Contraceptive">contraceptives</a>.<sup id="cite_ref-Weaver1999_56-2" class="reference"><a href="#cite_note-Weaver1999-56"><span class="cite-bracket">&#91;</span>56<span class="cite-bracket">&#93;</span></a></sup> More studies on the possible interactions between antibiotics and birth control pills (oral contraceptives) are required as well as careful assessment of patient-specific risk factors for potential oral contractive pill failure prior to dismissing the need for backup contraception.<sup id="cite_ref-OC_effectiveness_55-3" class="reference"><a href="#cite_note-OC_effectiveness-55"><span class="cite-bracket">&#91;</span>55<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Alcohol">Alcohol</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Antibiotic&amp;action=edit&amp;section=9" title="Edit section: Alcohol"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Interactions between alcohol and certain antibiotics may occur and may cause side effects and decreased effectiveness of antibiotic therapy.<sup id="cite_ref-bmj_60-0" class="reference"><a href="#cite_note-bmj-60"><span class="cite-bracket">&#91;</span>60<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-antibiotics-and-alcohol_61-0" class="reference"><a href="#cite_note-antibiotics-and-alcohol-61"><span class="cite-bracket">&#91;</span>61<span class="cite-bracket">&#93;</span></a></sup> While moderate alcohol consumption is unlikely to interfere with many common antibiotics, there are specific types of antibiotics with which alcohol consumption may cause serious side effects.<sup id="cite_ref-NHS_62-0" class="reference"><a href="#cite_note-NHS-62"><span class="cite-bracket">&#91;</span>62<span class="cite-bracket">&#93;</span></a></sup> Therefore, potential risks of side effects and effectiveness depend on the type of antibiotic administered.<sup id="cite_ref-63" class="reference"><a href="#cite_note-63"><span class="cite-bracket">&#91;</span>63<span class="cite-bracket">&#93;</span></a></sup> </p><p>Antibiotics such as <a href="/wiki/Metronidazole" title="Metronidazole">metronidazole</a>, <a href="/wiki/Tinidazole" title="Tinidazole">tinidazole</a>, <a href="/wiki/Cephamandole" class="mw-redirect" title="Cephamandole">cephamandole</a>, <a href="/wiki/Latamoxef" title="Latamoxef">latamoxef</a>, <a href="/wiki/Cefoperazone" title="Cefoperazone">cefoperazone</a>, <a href="/wiki/Cefmenoxime" title="Cefmenoxime">cefmenoxime</a>, and <a href="/wiki/Furazolidone" title="Furazolidone">furazolidone</a>, cause a <a href="/wiki/Disulfiram" title="Disulfiram">disulfiram</a>-like chemical reaction with alcohol by inhibiting its breakdown by <a href="/wiki/Acetaldehyde_dehydrogenase" title="Acetaldehyde dehydrogenase">acetaldehyde dehydrogenase</a>, which may result in vomiting, nausea, and shortness of breath.<sup id="cite_ref-NHS_62-1" class="reference"><a href="#cite_note-NHS-62"><span class="cite-bracket">&#91;</span>62<span class="cite-bracket">&#93;</span></a></sup> In addition, the efficacy of doxycycline and <a href="/wiki/Erythromycin" title="Erythromycin">erythromycin</a> succinate may be reduced by alcohol consumption.<sup id="cite_ref-64" class="reference"><a href="#cite_note-64"><span class="cite-bracket">&#91;</span>64<span class="cite-bracket">&#93;</span></a></sup> Other effects of alcohol on antibiotic activity include altered activity of the liver enzymes that break down the antibiotic compound.<sup id="cite_ref-Antibiotics_FAQ_29-1" class="reference"><a href="#cite_note-Antibiotics_FAQ-29"><span class="cite-bracket">&#91;</span>29<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Pharmacodynamics">Pharmacodynamics</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Antibiotic&amp;action=edit&amp;section=10" title="Edit section: Pharmacodynamics"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Antimicrobial_pharmacodynamics" title="Antimicrobial pharmacodynamics">Antimicrobial pharmacodynamics</a></div> <p>The successful outcome of antimicrobial therapy with antibacterial compounds depends on several factors. These include <a href="/wiki/Immune_system" title="Immune system">host defense mechanisms</a>, the location of infection, and the pharmacokinetic and pharmacodynamic properties of the antibacterial.<sup id="cite_ref-Pankey2004_65-0" class="reference"><a href="#cite_note-Pankey2004-65"><span class="cite-bracket">&#91;</span>65<span class="cite-bracket">&#93;</span></a></sup> The bactericidal activity of antibacterials may depend on the bacterial growth phase, and it often requires ongoing metabolic activity and division of bacterial cells.<sup id="cite_ref-Bactericidal_action_of_daptomycin_against_stationary-phase_and_nondividing_Staphylococcus_aureus_cells_66-0" class="reference"><a href="#cite_note-Bactericidal_action_of_daptomycin_against_stationary-phase_and_nondividing_Staphylococcus_aureus_cells-66"><span class="cite-bracket">&#91;</span>66<span class="cite-bracket">&#93;</span></a></sup> These findings are based on laboratory studies, and in clinical settings have also been shown to eliminate bacterial infection.<sup id="cite_ref-Pankey2004_65-1" class="reference"><a href="#cite_note-Pankey2004-65"><span class="cite-bracket">&#91;</span>65<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-67" class="reference"><a href="#cite_note-67"><span class="cite-bracket">&#91;</span>67<span class="cite-bracket">&#93;</span></a></sup> Since the activity of antibacterials depends frequently on its concentration,<sup id="cite_ref-Rhee2004_68-0" class="reference"><a href="#cite_note-Rhee2004-68"><span class="cite-bracket">&#91;</span>68<span class="cite-bracket">&#93;</span></a></sup> <i>in vitro</i> characterization of antibacterial activity commonly includes the determination of the <a href="/wiki/Minimum_inhibitory_concentration" title="Minimum inhibitory concentration">minimum inhibitory concentration</a> and minimum bactericidal concentration of an antibacterial.<sup id="cite_ref-Pankey2004_65-2" class="reference"><a href="#cite_note-Pankey2004-65"><span class="cite-bracket">&#91;</span>65<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-Agar_and_broth_dilution_methods_to_determine_the_minimal_inhibitory_concentration_(MIC)of_antimicrobial_substances_69-0" class="reference"><a href="#cite_note-Agar_and_broth_dilution_methods_to_determine_the_minimal_inhibitory_concentration_(MIC)of_antimicrobial_substances-69"><span class="cite-bracket">&#91;</span>69<span class="cite-bracket">&#93;</span></a></sup> To predict clinical outcome, the antimicrobial activity of an antibacterial is usually combined with its <a href="/wiki/Pharmacokinetics" title="Pharmacokinetics">pharmacokinetic</a> profile, and several pharmacological parameters are used as markers of drug efficacy.<sup id="cite_ref-70" class="reference"><a href="#cite_note-70"><span class="cite-bracket">&#91;</span>70<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Combination_therapy">Combination therapy</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Antibiotic&amp;action=edit&amp;section=11" title="Edit section: Combination therapy"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>In important infectious diseases, including tuberculosis, <a href="/wiki/Combination_therapy" title="Combination therapy">combination therapy</a> (i.e., the concurrent application of two or more antibiotics) has been used to delay or prevent the emergence of resistance. In acute bacterial infections, antibiotics as part of combination therapy are prescribed for their <a href="/wiki/Drug_synergy" class="mw-redirect" title="Drug synergy">synergistic</a> effects to improve treatment outcome as the combined effect of both antibiotics is better than their individual effect.<sup id="cite_ref-Antagonism_between_bacteriostatic_71-0" class="reference"><a href="#cite_note-Antagonism_between_bacteriostatic-71"><span class="cite-bracket">&#91;</span>71<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-Bollenbach_-_interactions_72-0" class="reference"><a href="#cite_note-Bollenbach_-_interactions-72"><span class="cite-bracket">&#91;</span>72<span class="cite-bracket">&#93;</span></a></sup> <a href="/wiki/Fosfomycin" title="Fosfomycin">Fosfomycin</a> has the highest number of synergistic combinations among antibiotics and is almost always used as a partner drug.<sup id="cite_ref-73" class="reference"><a href="#cite_note-73"><span class="cite-bracket">&#91;</span>73<span class="cite-bracket">&#93;</span></a></sup> <a href="/wiki/Methicillin-resistant_Staphylococcus_aureus" title="Methicillin-resistant Staphylococcus aureus">Methicillin-resistant <i>Staphylococcus aureus</i></a> infections may be treated with a combination therapy of <a href="/wiki/Fusidic_acid" title="Fusidic acid">fusidic acid</a> and rifampicin.<sup id="cite_ref-Antagonism_between_bacteriostatic_71-1" class="reference"><a href="#cite_note-Antagonism_between_bacteriostatic-71"><span class="cite-bracket">&#91;</span>71<span class="cite-bracket">&#93;</span></a></sup> Antibiotics used in combination may also be antagonistic and the combined effects of the two antibiotics may be less than if one of the antibiotics was given as a <a href="/wiki/Monotherapy" class="mw-redirect" title="Monotherapy">monotherapy</a>.<sup id="cite_ref-Antagonism_between_bacteriostatic_71-2" class="reference"><a href="#cite_note-Antagonism_between_bacteriostatic-71"><span class="cite-bracket">&#91;</span>71<span class="cite-bracket">&#93;</span></a></sup> For example, <a href="/wiki/Chloramphenicol" title="Chloramphenicol">chloramphenicol</a> and <a href="/wiki/Tetracyclines" class="mw-redirect" title="Tetracyclines">tetracyclines</a> are antagonists to <a href="/wiki/Penicillin" title="Penicillin">penicillins</a>. However, this can vary depending on the species of bacteria.<sup id="cite_ref-74" class="reference"><a href="#cite_note-74"><span class="cite-bracket">&#91;</span>74<span class="cite-bracket">&#93;</span></a></sup> In general, combinations of a bacteriostatic antibiotic and bactericidal antibiotic are antagonistic.<sup id="cite_ref-Antagonism_between_bacteriostatic_71-3" class="reference"><a href="#cite_note-Antagonism_between_bacteriostatic-71"><span class="cite-bracket">&#91;</span>71<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-Bollenbach_-_interactions_72-1" class="reference"><a href="#cite_note-Bollenbach_-_interactions-72"><span class="cite-bracket">&#91;</span>72<span class="cite-bracket">&#93;</span></a></sup> </p><p>In addition to combining one antibiotic with another, antibiotics are sometimes co-administered with resistance-modifying agents. For example, <a href="/wiki/%CE%92-lactam_antibiotics" class="mw-redirect" title="Β-lactam antibiotics">β-lactam antibiotics</a> may be used in combination with <a href="/wiki/Beta-lactamase_inhibitor" class="mw-redirect" title="Beta-lactamase inhibitor">β-lactamase inhibitors</a>, such as <a href="/wiki/Clavulanic_acid" title="Clavulanic acid">clavulanic acid</a> or <a href="/wiki/Sulbactam" title="Sulbactam">sulbactam</a>, when a patient is infected with a <a href="/wiki/Beta-lactamase" title="Beta-lactamase">β-lactamase</a>-producing strain of bacteria.<sup id="cite_ref-75" class="reference"><a href="#cite_note-75"><span class="cite-bracket">&#91;</span>75<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Classes">Classes</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Antibiotic&amp;action=edit&amp;section=12" title="Edit section: Classes"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/List_of_antibiotics" title="List of antibiotics">List of antibiotics</a></div> <div class="skin-invert-image"> <ul class="gallery mw-gallery-packed"> <li class="gallerybox" style="width: 344px"> <div class="thumb" style="width: 342px;"><span typeof="mw:File"><a href="/wiki/File:Antibiotics_action.svg" class="mw-file-description" title="Molecular targets of antibiotics on the bacteria cell"><img alt="Molecular targets of antibiotics on the bacteria cell" src="//upload.wikimedia.org/wikipedia/commons/thumb/0/08/Antibiotics_action.svg/513px-Antibiotics_action.svg.png" decoding="async" width="342" height="280" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/0/08/Antibiotics_action.svg/770px-Antibiotics_action.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/0/08/Antibiotics_action.svg/1027px-Antibiotics_action.svg.png 2x" data-file-width="2200" data-file-height="1800" /></a></span></div> <div class="gallerytext">Molecular targets of antibiotics on the bacteria cell</div> </li> <li class="gallerybox" style="width: 480px"> <div class="thumb" style="width: 478px;"><span typeof="mw:File"><a href="/wiki/File:Protein_synthesis_inhibitors_antibiotic.png" class="mw-file-description" title="Protein synthesis inhibitors (antibiotics)"><img alt="Protein synthesis inhibitors (antibiotics)" src="//upload.wikimedia.org/wikipedia/commons/thumb/d/da/Protein_synthesis_inhibitors_antibiotic.png/717px-Protein_synthesis_inhibitors_antibiotic.png" decoding="async" width="478" height="280" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/d/da/Protein_synthesis_inhibitors_antibiotic.png/1075px-Protein_synthesis_inhibitors_antibiotic.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/d/da/Protein_synthesis_inhibitors_antibiotic.png/1433px-Protein_synthesis_inhibitors_antibiotic.png 2x" data-file-width="4296" data-file-height="2519" /></a></span></div> <div class="gallerytext">Protein synthesis inhibitors (antibiotics)</div> </li> </ul> </div> <p>Antibiotics are commonly classified based on their <a href="/wiki/Mechanism_of_action" title="Mechanism of action">mechanism of action</a>, <a href="/wiki/Chemical_structure" title="Chemical structure">chemical structure</a>, or spectrum of activity. Most target bacterial functions or growth processes.<sup id="cite_ref-CALDERIN2007_8-2" class="reference"><a href="#cite_note-CALDERIN2007-8"><span class="cite-bracket">&#91;</span>8<span class="cite-bracket">&#93;</span></a></sup> Those that target the bacterial cell wall (<a href="/wiki/Penicillin" title="Penicillin">penicillins</a> and <a href="/wiki/Cephalosporin" title="Cephalosporin">cephalosporins</a>) or the cell membrane (<a href="/wiki/Polymyxin" title="Polymyxin">polymyxins</a>), or interfere with essential bacterial enzymes (<a href="/wiki/Rifamycin" title="Rifamycin">rifamycins</a>, <a href="/wiki/Lipiarmycin" class="mw-redirect" title="Lipiarmycin">lipiarmycins</a>, <a href="/wiki/Quinolone_antibiotic" title="Quinolone antibiotic">quinolones</a>, and <a href="/wiki/Sulfonamide_(medicine)" title="Sulfonamide (medicine)">sulfonamides</a>) have <a href="/wiki/Bactericide" title="Bactericide">bactericidal</a> activities, killing the bacteria. <a href="/wiki/Protein_synthesis_inhibitor" title="Protein synthesis inhibitor">Protein synthesis inhibitors</a> (<a href="/wiki/Macrolide" title="Macrolide">macrolides</a>, <a href="/wiki/Lincosamides" title="Lincosamides">lincosamides</a>, and <a href="/wiki/Tetracycline" title="Tetracycline">tetracyclines</a>) are usually <a href="/wiki/Bacteriostatic" class="mw-redirect" title="Bacteriostatic">bacteriostatic</a>, inhibiting further growth (with the exception of bactericidal <a href="/wiki/Aminoglycoside" title="Aminoglycoside">aminoglycosides</a>).<sup id="cite_ref-The_importance_of_bactericidal_drugs:_future_directions_in_infectious_disease_76-0" class="reference"><a href="#cite_note-The_importance_of_bactericidal_drugs:_future_directions_in_infectious_disease-76"><span class="cite-bracket">&#91;</span>76<span class="cite-bracket">&#93;</span></a></sup> Further categorization is based on their target specificity. "Narrow-spectrum" antibiotics target specific types of bacteria, such as <a href="/wiki/Gram-negative" class="mw-redirect" title="Gram-negative">gram-negative</a> or <a href="/wiki/Gram-positive" class="mw-redirect" title="Gram-positive">gram-positive</a>, whereas <a href="/wiki/Broad-spectrum_antibiotics" class="mw-redirect" title="Broad-spectrum antibiotics">broad-spectrum antibiotics</a> affect a wide range of bacteria. Following a 40-year break in discovering classes of antibacterial compounds, four new classes of antibiotics were introduced to clinical use in the late 2000s and early 2010s: cyclic <a href="/wiki/Lipopeptide" title="Lipopeptide">lipopeptides</a> (such as <a href="/wiki/Daptomycin" title="Daptomycin">daptomycin</a>), <a href="/wiki/Glycylcyclines" class="mw-redirect" title="Glycylcyclines">glycylcyclines</a> (such as <a href="/wiki/Tigecycline" title="Tigecycline">tigecycline</a>), <a href="/wiki/Oxazolidinone" class="mw-redirect" title="Oxazolidinone">oxazolidinones</a> (such as <a href="/wiki/Linezolid" title="Linezolid">linezolid</a>), and <a href="/wiki/Lipiarmycin" class="mw-redirect" title="Lipiarmycin">lipiarmycins</a> (such as <a href="/wiki/Fidaxomicin" title="Fidaxomicin">fidaxomicin</a>).<sup id="cite_ref-77" class="reference"><a href="#cite_note-77"><span class="cite-bracket">&#91;</span>77<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-78" class="reference"><a href="#cite_note-78"><span class="cite-bracket">&#91;</span>78<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Production">Production</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Antibiotic&amp;action=edit&amp;section=13" title="Edit section: Production"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Production_of_antibiotics" title="Production of antibiotics">Production of antibiotics</a></div> <p>With advances in <a href="/wiki/Medicinal_chemistry" title="Medicinal chemistry">medicinal chemistry</a>, most modern antibacterials are <a href="/wiki/Semisynthetic" class="mw-redirect" title="Semisynthetic">semisynthetic</a> modifications of various natural compounds.<sup id="cite_ref-Nussbaum2006_79-0" class="reference"><a href="#cite_note-Nussbaum2006-79"><span class="cite-bracket">&#91;</span>79<span class="cite-bracket">&#93;</span></a></sup> These include, for example, the <a href="/wiki/Beta-lactam_antibiotics" class="mw-redirect" title="Beta-lactam antibiotics">beta-lactam antibiotics</a>, which include the <a href="/wiki/Penicillin" title="Penicillin">penicillins</a> (produced by fungi in the genus <i><a href="/wiki/Penicillium" title="Penicillium">Penicillium</a></i>), the <a href="/wiki/Cephalosporin" title="Cephalosporin">cephalosporins</a>, and the <a href="/wiki/Carbapenem" title="Carbapenem">carbapenems</a>. Compounds that are still isolated from living organisms are the <a href="/wiki/Aminoglycoside" title="Aminoglycoside">aminoglycosides</a>, whereas other antibacterials—for example, the <a href="/wiki/Sulfonamide_(medicine)" title="Sulfonamide (medicine)">sulfonamides</a>, the <a href="/wiki/Quinolone_antibiotic" title="Quinolone antibiotic">quinolones</a>, and the <a href="/wiki/Oxazolidinone" class="mw-redirect" title="Oxazolidinone">oxazolidinones</a>—are produced solely by <a href="/wiki/Chemical_synthesis" title="Chemical synthesis">chemical synthesis</a>.<sup id="cite_ref-Nussbaum2006_79-1" class="reference"><a href="#cite_note-Nussbaum2006-79"><span class="cite-bracket">&#91;</span>79<span class="cite-bracket">&#93;</span></a></sup> Many antibacterial compounds are relatively <a href="/wiki/Small_molecule" title="Small molecule">small molecules</a> with a <a href="/wiki/Molecular_weight" class="mw-redirect" title="Molecular weight">molecular weight</a> of less than 1000 <a href="/wiki/Dalton_(unit)" title="Dalton (unit)">daltons</a>.<sup id="cite_ref-80" class="reference"><a href="#cite_note-80"><span class="cite-bracket">&#91;</span>80<span class="cite-bracket">&#93;</span></a></sup> </p><p>Since the first pioneering efforts of <a href="/wiki/Howard_Florey" title="Howard Florey">Howard Florey</a> and <a href="/wiki/Ernst_Boris_Chain" class="mw-redirect" title="Ernst Boris Chain">Chain</a> in 1939, the importance of antibiotics, including antibacterials, to <a href="/wiki/Medicine" title="Medicine">medicine</a> has led to intense research into producing antibacterials at large scales. Following screening of antibacterials against a wide range of <a href="/wiki/Bacteria" title="Bacteria">bacteria</a>, production of the active compounds is carried out using <a href="/wiki/Industrial_fermentation" title="Industrial fermentation">fermentation</a>, usually in strongly <a href="https://en.wiktionary.org/wiki/aerobic" class="extiw" title="wikt:aerobic">aerobic</a> conditions.<sup id="cite_ref-81" class="reference"><a href="#cite_note-81"><span class="cite-bracket">&#91;</span>81<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Resistance">Resistance</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Antibiotic&amp;action=edit&amp;section=14" title="Edit section: Resistance"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Antimicrobial_resistance" title="Antimicrobial resistance">Antimicrobial resistance</a></div> <figure class="mw-default-size mw-halign-left" typeof="mw:File/Thumb"><a href="/wiki/File:Human_neutrophil_ingesting_MRSA.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/0/01/Human_neutrophil_ingesting_MRSA.jpg/220px-Human_neutrophil_ingesting_MRSA.jpg" decoding="async" width="220" height="291" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/0/01/Human_neutrophil_ingesting_MRSA.jpg/330px-Human_neutrophil_ingesting_MRSA.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/0/01/Human_neutrophil_ingesting_MRSA.jpg/440px-Human_neutrophil_ingesting_MRSA.jpg 2x" data-file-width="1894" data-file-height="2501" /></a><figcaption><a href="/wiki/Scanning_electron_micrograph" class="mw-redirect" title="Scanning electron micrograph">Scanning electron micrograph</a> of a human <a href="/wiki/Neutrophil" title="Neutrophil">neutrophil</a> ingesting <a href="/wiki/Methicillin-resistant_Staphylococcus_aureus" title="Methicillin-resistant Staphylococcus aureus">methicillin-resistant <i>Staphylococcus aureus</i></a> (MRSA)</figcaption></figure> <p>Antimicrobial resistance (AMR or AR) is a naturally occurring process.<sup id="cite_ref-CDC_About_Antimicrobial_Resistance_16-1" class="reference"><a href="#cite_note-CDC_About_Antimicrobial_Resistance-16"><span class="cite-bracket">&#91;</span>16<span class="cite-bracket">&#93;</span></a></sup> AMR is driven largely by the misuse and overuse of antimicrobials.<sup id="cite_ref-WHO10October2024_17-3" class="reference"><a href="#cite_note-WHO10October2024-17"><span class="cite-bracket">&#91;</span>17<span class="cite-bracket">&#93;</span></a></sup> Yet, at the same time, many people around the world do not have access to essential antimicrobials.<sup id="cite_ref-WHO10October2024_17-4" class="reference"><a href="#cite_note-WHO10October2024-17"><span class="cite-bracket">&#91;</span>17<span class="cite-bracket">&#93;</span></a></sup> The emergence of <a href="/wiki/List_of_antibiotic-resistant_bacteria" title="List of antibiotic-resistant bacteria">antibiotic-resistant bacteria</a> is a common phenomenon mainly caused by the overuse/misuse. It represents a threat to health globally.<sup id="cite_ref-82" class="reference"><a href="#cite_note-82"><span class="cite-bracket">&#91;</span>82<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-:1_83-0" class="reference"><a href="#cite_note-:1-83"><span class="cite-bracket">&#91;</span>83<span class="cite-bracket">&#93;</span></a></sup> Each year, nearly 5 million deaths are associated with AMR globally.<sup id="cite_ref-WHO10October2024_17-5" class="reference"><a href="#cite_note-WHO10October2024-17"><span class="cite-bracket">&#91;</span>17<span class="cite-bracket">&#93;</span></a></sup> </p><p>Emergence of resistance often reflects <a href="/wiki/Evolution" title="Evolution">evolutionary</a> processes that take place during antibiotic therapy. The antibiotic treatment may <a href="/wiki/Natural_selection" title="Natural selection">select</a> for bacterial strains with physiologically or genetically enhanced capacity to survive high doses of antibiotics. Under certain conditions, it may result in preferential growth of resistant bacteria, while growth of susceptible bacteria is inhibited by the drug.<sup id="cite_ref-Balancing_the_drug-resistance_equation_84-0" class="reference"><a href="#cite_note-Balancing_the_drug-resistance_equation-84"><span class="cite-bracket">&#91;</span>84<span class="cite-bracket">&#93;</span></a></sup> For example, antibacterial selection for strains having previously acquired antibacterial-resistance genes was demonstrated in 1943 by the <a href="/wiki/Luria%E2%80%93Delbr%C3%BCck_experiment" title="Luria–Delbrück experiment">Luria–Delbrück experiment</a>.<sup id="cite_ref-Mutations_of_Bacteria_from_Virus_Sensitivity_to_Virus_Resistance_85-0" class="reference"><a href="#cite_note-Mutations_of_Bacteria_from_Virus_Sensitivity_to_Virus_Resistance-85"><span class="cite-bracket">&#91;</span>85<span class="cite-bracket">&#93;</span></a></sup> Antibiotics such as penicillin and erythromycin, which used to have a high efficacy against many bacterial species and strains, have become less effective, due to the increased resistance of many bacterial strains.<sup id="cite_ref-voanews.com_86-0" class="reference"><a href="#cite_note-voanews.com-86"><span class="cite-bracket">&#91;</span>86<span class="cite-bracket">&#93;</span></a></sup> </p><p>Resistance may take the form of biodegradation of pharmaceuticals, such as sulfamethazine-degrading soil bacteria introduced to sulfamethazine through medicated pig feces.<sup id="cite_ref-87" class="reference"><a href="#cite_note-87"><span class="cite-bracket">&#91;</span>87<span class="cite-bracket">&#93;</span></a></sup> The survival of bacteria often results from an inheritable resistance,<sup id="cite_ref-Witte2004_88-0" class="reference"><a href="#cite_note-Witte2004-88"><span class="cite-bracket">&#91;</span>88<span class="cite-bracket">&#93;</span></a></sup> but the growth of resistance to antibacterials also occurs through <a href="/wiki/Horizontal_gene_transfer" title="Horizontal gene transfer">horizontal gene transfer</a>. Horizontal transfer is more likely to happen in locations of frequent antibiotic use.<sup id="cite_ref-89" class="reference"><a href="#cite_note-89"><span class="cite-bracket">&#91;</span>89<span class="cite-bracket">&#93;</span></a></sup> </p><p>Antibacterial resistance may impose a biological cost, thereby reducing <a href="/wiki/Biological_fitness" class="mw-redirect" title="Biological fitness">fitness</a> of resistant strains, which can limit the spread of antibacterial-resistant bacteria, for example, in the absence of antibacterial compounds. Additional mutations, however, may compensate for this fitness cost and can aid the survival of these bacteria.<sup id="cite_ref-The_biological_cost_of_mutational_antibiotic_resistance:_any_practical_conclusions?_90-0" class="reference"><a href="#cite_note-The_biological_cost_of_mutational_antibiotic_resistance:_any_practical_conclusions?-90"><span class="cite-bracket">&#91;</span>90<span class="cite-bracket">&#93;</span></a></sup> </p><p>Paleontological data show that both antibiotics and antibiotic resistance are ancient compounds and mechanisms.<sup id="cite_ref-D&#39;Costa2011_91-0" class="reference"><a href="#cite_note-D&#39;Costa2011-91"><span class="cite-bracket">&#91;</span>91<span class="cite-bracket">&#93;</span></a></sup> Useful antibiotic targets are those for which mutations negatively impact bacterial reproduction or viability.<sup id="cite_ref-Gladki2013_92-0" class="reference"><a href="#cite_note-Gladki2013-92"><span class="cite-bracket">&#91;</span>92<span class="cite-bracket">&#93;</span></a></sup> </p><p>Several molecular mechanisms of antibacterial resistance exist. Intrinsic antibacterial resistance may be part of the genetic makeup of bacterial strains.<sup id="cite_ref-Alekshun2007_93-0" class="reference"><a href="#cite_note-Alekshun2007-93"><span class="cite-bracket">&#91;</span>93<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-94" class="reference"><a href="#cite_note-94"><span class="cite-bracket">&#91;</span>94<span class="cite-bracket">&#93;</span></a></sup> For example, an antibiotic target may be absent from the bacterial <a href="/wiki/Genome" title="Genome">genome</a>. Acquired resistance results from a mutation in the bacterial chromosome or the acquisition of extra-chromosomal DNA.<sup id="cite_ref-Alekshun2007_93-1" class="reference"><a href="#cite_note-Alekshun2007-93"><span class="cite-bracket">&#91;</span>93<span class="cite-bracket">&#93;</span></a></sup> Antibacterial-producing bacteria have evolved resistance mechanisms that have been shown to be similar to, and may have been transferred to, antibacterial-resistant strains.<sup id="cite_ref-Glycopeptide_antibiotic_resistance_genes_in_glycopeptide-producing_organisms_95-0" class="reference"><a href="#cite_note-Glycopeptide_antibiotic_resistance_genes_in_glycopeptide-producing_organisms-95"><span class="cite-bracket">&#91;</span>95<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-Multidrug_Resistance_in_Bacteria_96-0" class="reference"><a href="#cite_note-Multidrug_Resistance_in_Bacteria-96"><span class="cite-bracket">&#91;</span>96<span class="cite-bracket">&#93;</span></a></sup> The spread of antibacterial resistance often occurs through vertical transmission of mutations during growth and by genetic recombination of DNA by <a href="/wiki/Horizontal_gene_transfer" title="Horizontal gene transfer">horizontal genetic exchange</a>.<sup id="cite_ref-Witte2004_88-1" class="reference"><a href="#cite_note-Witte2004-88"><span class="cite-bracket">&#91;</span>88<span class="cite-bracket">&#93;</span></a></sup> For instance, antibacterial resistance genes can be exchanged between different bacterial strains or species via <a href="/wiki/Plasmids" class="mw-redirect" title="Plasmids">plasmids</a> that carry these resistance genes.<sup id="cite_ref-Witte2004_88-2" class="reference"><a href="#cite_note-Witte2004-88"><span class="cite-bracket">&#91;</span>88<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-Baker2006_97-0" class="reference"><a href="#cite_note-Baker2006-97"><span class="cite-bracket">&#91;</span>97<span class="cite-bracket">&#93;</span></a></sup> Plasmids that carry several different resistance genes can confer resistance to multiple antibacterials.<sup id="cite_ref-Baker2006_97-1" class="reference"><a href="#cite_note-Baker2006-97"><span class="cite-bracket">&#91;</span>97<span class="cite-bracket">&#93;</span></a></sup> Cross-resistance to several antibacterials may also occur when a resistance mechanism encoded by a single gene conveys resistance to more than one antibacterial compound.<sup id="cite_ref-Baker2006_97-2" class="reference"><a href="#cite_note-Baker2006-97"><span class="cite-bracket">&#91;</span>97<span class="cite-bracket">&#93;</span></a></sup> </p><p>Antibacterial-resistant strains and species, sometimes referred to as "superbugs", now contribute to the emergence of diseases that were, for a while, well controlled. For example, emergent bacterial strains causing tuberculosis that are resistant to previously effective antibacterial treatments pose many therapeutic challenges. Every year, nearly half a million new cases of <a href="/wiki/Multidrug-resistant_tuberculosis" title="Multidrug-resistant tuberculosis">multidrug-resistant tuberculosis</a> (MDR-TB) are estimated to occur worldwide.<sup id="cite_ref-98" class="reference"><a href="#cite_note-98"><span class="cite-bracket">&#91;</span>98<span class="cite-bracket">&#93;</span></a></sup> For example, <a href="/wiki/NDM-1" class="mw-redirect" title="NDM-1">NDM-1</a> is a newly identified enzyme conveying bacterial resistance to a broad range of <a href="/wiki/Beta-lactam" class="mw-redirect" title="Beta-lactam">beta-lactam</a> antibacterials.<sup id="cite_ref-Are_you_ready_for_a_world_without_antibiotics?_99-0" class="reference"><a href="#cite_note-Are_you_ready_for_a_world_without_antibiotics?-99"><span class="cite-bracket">&#91;</span>99<span class="cite-bracket">&#93;</span></a></sup> The United Kingdom's <a href="/wiki/Health_Protection_Agency" title="Health Protection Agency">Health Protection Agency</a> has stated that "most isolates with NDM-1 enzyme are resistant to all standard intravenous antibiotics for treatment of severe infections."<sup id="cite_ref-Health_Protection_Report_100-0" class="reference"><a href="#cite_note-Health_Protection_Report-100"><span class="cite-bracket">&#91;</span>100<span class="cite-bracket">&#93;</span></a></sup> On 26 May 2016, an <a href="/wiki/Escherichia_coli" title="Escherichia coli"><i>E. coli</i></a> "<a href="/wiki/Antimicrobial_resistance" title="Antimicrobial resistance">superbug</a>" was identified in the United States resistant to <a href="/wiki/Colistin" title="Colistin">colistin</a>, <a href="/wiki/Drug_of_last_resort" title="Drug of last resort">"the last line of defence" antibiotic</a>.<sup id="cite_ref-101" class="reference"><a href="#cite_note-101"><span class="cite-bracket">&#91;</span>101<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-102" class="reference"><a href="#cite_note-102"><span class="cite-bracket">&#91;</span>102<span class="cite-bracket">&#93;</span></a></sup> In recent years, even anaerobic bacteria, historically considered less concerning in terms of resistance, have demonstrated high rates of antibiotic resistance, particularly <i><a href="/wiki/Bacteroides" title="Bacteroides">Bacteroides</a></i>, for which resistance rates to penicillin have been reported to exceed 90%.<sup id="cite_ref-103" class="reference"><a href="#cite_note-103"><span class="cite-bracket">&#91;</span>103<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Misuse">Misuse</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Antibiotic&amp;action=edit&amp;section=15" title="Edit section: Misuse"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:CDC_Get_Smart_poster_healthy_adult.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/6/6d/CDC_Get_Smart_poster_healthy_adult.png/220px-CDC_Get_Smart_poster_healthy_adult.png" decoding="async" width="220" height="285" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/6/6d/CDC_Get_Smart_poster_healthy_adult.png/330px-CDC_Get_Smart_poster_healthy_adult.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/6/6d/CDC_Get_Smart_poster_healthy_adult.png/440px-CDC_Get_Smart_poster_healthy_adult.png 2x" data-file-width="1545" data-file-height="2000" /></a><figcaption>This poster from the US Centers for Disease Control and Prevention "Get Smart" campaign, intended for use in doctors' offices and other healthcare facilities, warns that antibiotics do not work for viral illnesses such as the common cold.</figcaption></figure> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Antibiotic_misuse" title="Antibiotic misuse">Antibiotic misuse</a></div> <p>Per <i>The ICU Book</i>, "The first rule of antibiotics is to try not to use them, and the second rule is try not to use too many of them."<sup id="cite_ref-Marino_104-0" class="reference"><a href="#cite_note-Marino-104"><span class="cite-bracket">&#91;</span>104<span class="cite-bracket">&#93;</span></a></sup> Inappropriate antibiotic treatment and overuse of antibiotics have contributed to the emergence of antibiotic-resistant bacteria. However, potential harm from antibiotics extends beyond selection of antimicrobial resistance and their overuse is associated with adverse effects for patients themselves, seen most clearly in <a href="/wiki/Critically_ill" class="mw-redirect" title="Critically ill">critically ill</a> patients in <a href="/wiki/Intensive_care_unit" title="Intensive care unit">Intensive care units</a>.<sup id="cite_ref-:0_105-0" class="reference"><a href="#cite_note-:0-105"><span class="cite-bracket">&#91;</span>105<span class="cite-bracket">&#93;</span></a></sup> <a href="/wiki/Self-prescribing" class="mw-redirect" title="Self-prescribing">Self-prescribing</a> of antibiotics is an example of misuse.<sup id="cite_ref-Larson2007_106-0" class="reference"><a href="#cite_note-Larson2007-106"><span class="cite-bracket">&#91;</span>106<span class="cite-bracket">&#93;</span></a></sup> Many antibiotics are frequently prescribed to treat symptoms or diseases that do not respond to antibiotics or that are likely to resolve without treatment. Also, incorrect or suboptimal antibiotics are prescribed for certain bacterial infections.<sup id="cite_ref-pmid15993671_45-1" class="reference"><a href="#cite_note-pmid15993671-45"><span class="cite-bracket">&#91;</span>45<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-Larson2007_106-1" class="reference"><a href="#cite_note-Larson2007-106"><span class="cite-bracket">&#91;</span>106<span class="cite-bracket">&#93;</span></a></sup> The overuse of antibiotics, like penicillin and erythromycin, has been associated with emerging antibiotic resistance since the 1950s.<sup id="cite_ref-voanews.com_86-1" class="reference"><a href="#cite_note-voanews.com-86"><span class="cite-bracket">&#91;</span>86<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-Hawkey2008_107-0" class="reference"><a href="#cite_note-Hawkey2008-107"><span class="cite-bracket">&#91;</span>107<span class="cite-bracket">&#93;</span></a></sup> Widespread usage of antibiotics in hospitals has also been associated with increases in bacterial strains and species that no longer respond to treatment with the most common antibiotics.<sup id="cite_ref-Hawkey2008_107-1" class="reference"><a href="#cite_note-Hawkey2008-107"><span class="cite-bracket">&#91;</span>107<span class="cite-bracket">&#93;</span></a></sup> </p><p>Common forms of antibiotic misuse include excessive use of <a href="/wiki/Prophylaxis" class="mw-redirect" title="Prophylaxis">prophylactic</a> antibiotics in travelers and failure of medical professionals to prescribe the correct dosage of antibiotics on the basis of the patient's weight and history of prior use. Other forms of misuse include failure to take the entire prescribed course of the antibiotic, incorrect dosage and administration, or failure to rest for sufficient recovery. Inappropriate antibiotic treatment, for example, is their prescription to treat viral infections such as the <a href="/wiki/Common_cold" title="Common cold">common cold</a>. One study on <a href="/wiki/Respiratory_tract_infection" title="Respiratory tract infection">respiratory tract infections</a> found "physicians were more likely to prescribe antibiotics to patients who appeared to expect them".<sup id="cite_ref-pmid17467120_108-0" class="reference"><a href="#cite_note-pmid17467120-108"><span class="cite-bracket">&#91;</span>108<span class="cite-bracket">&#93;</span></a></sup> Multifactorial interventions aimed at both physicians and patients can reduce inappropriate prescription of antibiotics.<sup id="cite_ref-pmid17509729_109-0" class="reference"><a href="#cite_note-pmid17509729-109"><span class="cite-bracket">&#91;</span>109<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-110" class="reference"><a href="#cite_note-110"><span class="cite-bracket">&#91;</span>110<span class="cite-bracket">&#93;</span></a></sup> The lack of rapid point of care diagnostic tests, particularly in resource-limited settings is considered one of the drivers of antibiotic misuse.<sup id="cite_ref-111" class="reference"><a href="#cite_note-111"><span class="cite-bracket">&#91;</span>111<span class="cite-bracket">&#93;</span></a></sup> </p><p>Several organizations concerned with antimicrobial resistance are lobbying to eliminate the unnecessary use of antibiotics.<sup id="cite_ref-Larson2007_106-2" class="reference"><a href="#cite_note-Larson2007-106"><span class="cite-bracket">&#91;</span>106<span class="cite-bracket">&#93;</span></a></sup> The issues of misuse and overuse of antibiotics have been addressed by the formation of the US Interagency Task Force on Antimicrobial Resistance. This task force aims to actively address antimicrobial resistance, and is coordinated by the US <a href="/wiki/Centers_for_Disease_Control_and_Prevention" title="Centers for Disease Control and Prevention">Centers for Disease Control and Prevention</a>, the <a href="/wiki/Food_and_Drug_Administration" title="Food and Drug Administration">Food and Drug Administration</a> (FDA), and the <a href="/wiki/National_Institutes_of_Health" title="National Institutes of Health">National Institutes of Health</a>, as well as other US agencies.<sup id="cite_ref-pharmguide_112-0" class="reference"><a href="#cite_note-pharmguide-112"><span class="cite-bracket">&#91;</span>112<span class="cite-bracket">&#93;</span></a></sup> A non-governmental organization campaign group is <i>Keep Antibiotics Working</i>.<sup id="cite_ref-Keep_Antibiotics_Working_113-0" class="reference"><a href="#cite_note-Keep_Antibiotics_Working-113"><span class="cite-bracket">&#91;</span>113<span class="cite-bracket">&#93;</span></a></sup> In France, an "Antibiotics are not automatic" government campaign started in 2002 and led to a marked reduction of unnecessary antibiotic prescriptions, especially in children.<sup id="cite_ref-114" class="reference"><a href="#cite_note-114"><span class="cite-bracket">&#91;</span>114<span class="cite-bracket">&#93;</span></a></sup> </p><p>The emergence of antibiotic resistance has prompted restrictions on their use in the UK in 1970 (Swann report 1969), and the European Union has banned the use of antibiotics as growth-promotional agents since 2003.<sup id="cite_ref-115" class="reference"><a href="#cite_note-115"><span class="cite-bracket">&#91;</span>115<span class="cite-bracket">&#93;</span></a></sup> Moreover, several organizations (including the World Health Organization, the <a href="/wiki/National_Academy_of_Sciences" title="National Academy of Sciences">National Academy of Sciences</a>, and the <a href="/wiki/U.S._Food_and_Drug_Administration" class="mw-redirect" title="U.S. Food and Drug Administration">U.S. Food and Drug Administration</a>) have advocated restricting the amount of antibiotic use in food animal production.<sup id="cite_ref-116" class="reference"><a href="#cite_note-116"><span class="cite-bracket">&#91;</span>116<span class="cite-bracket">&#93;</span></a></sup><sup class="noprint Inline-Template" style="white-space:nowrap;">&#91;<i><a href="/wiki/Wikipedia:Identifying_reliable_sources_(medicine)" title="Wikipedia:Identifying reliable sources (medicine)"><span title="Material near this tag may rely on an unreliable or less reliable medical source. (July 2016)">unreliable medical source?</span></a></i>&#93;</sup> However, commonly there are delays in regulatory and legislative actions to limit the use of antibiotics, attributable partly to resistance against such regulation by industries using or selling antibiotics, and to the time required for research to test causal links between their use and resistance to them. Two federal bills (S.742<sup id="cite_ref-USbill1_117-0" class="reference"><a href="#cite_note-USbill1-117"><span class="cite-bracket">&#91;</span>117<span class="cite-bracket">&#93;</span></a></sup> and H.R. 2562<sup id="cite_ref-USbill2_118-0" class="reference"><a href="#cite_note-USbill2-118"><span class="cite-bracket">&#91;</span>118<span class="cite-bracket">&#93;</span></a></sup>) aimed at phasing out nontherapeutic use of antibiotics in US food animals were proposed, but have not passed.<sup id="cite_ref-USbill1_117-1" class="reference"><a href="#cite_note-USbill1-117"><span class="cite-bracket">&#91;</span>117<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-USbill2_118-1" class="reference"><a href="#cite_note-USbill2-118"><span class="cite-bracket">&#91;</span>118<span class="cite-bracket">&#93;</span></a></sup> These bills were endorsed by public health and medical organizations, including the American Holistic Nurses' Association, the <a href="/wiki/American_Medical_Association" title="American Medical Association">American Medical Association</a>, and the <a href="/wiki/American_Public_Health_Association" title="American Public Health Association">American Public Health Association</a>.<sup id="cite_ref-119" class="reference"><a href="#cite_note-119"><span class="cite-bracket">&#91;</span>119<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-120" class="reference"><a href="#cite_note-120"><span class="cite-bracket">&#91;</span>120<span class="cite-bracket">&#93;</span></a></sup> </p><p>Despite pledges by food companies and restaurants to reduce or eliminate meat that comes from animals treated with antibiotics, the purchase of antibiotics for use on farm animals has been increasing every year.<sup id="cite_ref-121" class="reference"><a href="#cite_note-121"><span class="cite-bracket">&#91;</span>121<span class="cite-bracket">&#93;</span></a></sup> </p><p>There has been extensive use of antibiotics in animal husbandry. In the United States, the question of emergence of antibiotic-resistant bacterial strains due to <a href="/wiki/Antibiotic_use_in_livestock" title="Antibiotic use in livestock">use of antibiotics in livestock</a> was raised by the US <a href="/wiki/Food_and_Drug_Administration" title="Food and Drug Administration">Food and Drug Administration</a> (FDA) in 1977. In March 2012, the United States District Court for the Southern District of New York, ruling in an action brought by the <a href="/wiki/Natural_Resources_Defense_Council" title="Natural Resources Defense Council">Natural Resources Defense Council</a> and others, ordered the FDA to revoke approvals for the use of antibiotics in livestock, which violated FDA regulations.<sup id="cite_ref-122" class="reference"><a href="#cite_note-122"><span class="cite-bracket">&#91;</span>122<span class="cite-bracket">&#93;</span></a></sup> </p><p>Studies have shown that <a href="/wiki/Common_misconceptions" class="mw-redirect" title="Common misconceptions">common misconceptions</a> about the effectiveness and necessity of antibiotics to treat common mild illnesses contribute to their overuse.<sup id="cite_ref-123" class="reference"><a href="#cite_note-123"><span class="cite-bracket">&#91;</span>123<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-124" class="reference"><a href="#cite_note-124"><span class="cite-bracket">&#91;</span>124<span class="cite-bracket">&#93;</span></a></sup> </p><p>Other forms of antibiotic-associated harm include <a href="/wiki/Anaphylaxis" title="Anaphylaxis">anaphylaxis</a>, <a href="/wiki/Adverse_drug_reaction" title="Adverse drug reaction">drug toxicity</a> most notably kidney and liver damage, and super-infections with resistant organisms. Antibiotics are also known to affect <a href="/wiki/Mitochondrion" title="Mitochondrion">mitochondrial</a> function,<sup id="cite_ref-125" class="reference"><a href="#cite_note-125"><span class="cite-bracket">&#91;</span>125<span class="cite-bracket">&#93;</span></a></sup> and this may contribute to the <a href="/w/index.php?title=Bioenergetic_failure&amp;action=edit&amp;redlink=1" class="new" title="Bioenergetic failure (page does not exist)">bioenergetic failure</a> of <a href="/wiki/White_blood_cell" title="White blood cell">immune cells</a> seen in <a href="/wiki/Sepsis" title="Sepsis">sepsis</a>.<sup id="cite_ref-126" class="reference"><a href="#cite_note-126"><span class="cite-bracket">&#91;</span>126<span class="cite-bracket">&#93;</span></a></sup> They also alter the <a href="/wiki/Microbiome_of_humans" class="mw-redirect" title="Microbiome of humans">microbiome</a> of the gut, lungs, and skin,<sup id="cite_ref-127" class="reference"><a href="#cite_note-127"><span class="cite-bracket">&#91;</span>127<span class="cite-bracket">&#93;</span></a></sup> which may be associated with adverse effects such as <a href="/wiki/Clostridioides_difficile_infection" title="Clostridioides difficile infection">Clostridioides difficile associated diarrhoea</a>. Whilst antibiotics can clearly be lifesaving in patients with bacterial infections, their overuse, especially in patients where infections are hard to diagnose, can lead to harm via multiple mechanisms.<sup id="cite_ref-:0_105-1" class="reference"><a href="#cite_note-:0-105"><span class="cite-bracket">&#91;</span>105<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="History">History</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Antibiotic&amp;action=edit&amp;section=16" title="Edit section: History"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">For a chronological guide, see <a href="/wiki/Timeline_of_antibiotics" title="Timeline of antibiotics">Timeline of antibiotics</a>.</div> <p>Before the early 20th century, treatments for infections were based primarily on <a href="/wiki/Folk_medicine" class="mw-redirect" title="Folk medicine">medicinal folklore</a>. Mixtures with antimicrobial properties that were used in treatments of infections were described over 2,000 years ago.<sup id="cite_ref-Considerations_for_Determining_if_a_Natural_Product_Is_an_Effective_Wound-Healing_Agent_128-0" class="reference"><a href="#cite_note-Considerations_for_Determining_if_a_Natural_Product_Is_an_Effective_Wound-Healing_Agent-128"><span class="cite-bracket">&#91;</span>128<span class="cite-bracket">&#93;</span></a></sup> Many ancient cultures, including the <a href="/wiki/Ancient_Egyptian_medicine" title="Ancient Egyptian medicine">ancient Egyptians</a> and <a href="/wiki/Ancient_Greek_medicine" title="Ancient Greek medicine">ancient Greeks</a>, used specially selected <a href="/wiki/Mold_(fungus)" class="mw-redirect" title="Mold (fungus)">mold</a> and plant materials to treat <a href="/wiki/Infection" title="Infection">infections</a>.<sup id="cite_ref-Early_history_of_wound_treatment_129-0" class="reference"><a href="#cite_note-Early_history_of_wound_treatment-129"><span class="cite-bracket">&#91;</span>129<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-Moulds_in_ancient_and_more_recent_medicine_130-0" class="reference"><a href="#cite_note-Moulds_in_ancient_and_more_recent_medicine-130"><span class="cite-bracket">&#91;</span>130<span class="cite-bracket">&#93;</span></a></sup> <a href="/wiki/Nubian_people" class="mw-redirect" title="Nubian people">Nubian</a> mummies studied in the 1990s were found to contain significant levels of <a href="/wiki/Tetracycline" title="Tetracycline">tetracycline</a>. The beer brewed at that time was conjectured to have been the source.<sup id="cite_ref-131" class="reference"><a href="#cite_note-131"><span class="cite-bracket">&#91;</span>131<span class="cite-bracket">&#93;</span></a></sup> </p><p>The use of antibiotics in modern medicine began with the discovery of synthetic antibiotics derived from dyes.<sup id="cite_ref-CALDERIN2007_8-3" class="reference"><a href="#cite_note-CALDERIN2007-8"><span class="cite-bracket">&#91;</span>8<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-Limbird2004_132-0" class="reference"><a href="#cite_note-Limbird2004-132"><span class="cite-bracket">&#91;</span>132<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-Bosch2008_11-1" class="reference"><a href="#cite_note-Bosch2008-11"><span class="cite-bracket">&#91;</span>11<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-ReferenceB_133-0" class="reference"><a href="#cite_note-ReferenceB-133"><span class="cite-bracket">&#91;</span>133<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-goodman_9-1" class="reference"><a href="#cite_note-goodman-9"><span class="cite-bracket">&#91;</span>9<span class="cite-bracket">&#93;</span></a></sup> Various <a href="/wiki/Essential_oil" title="Essential oil">Essential oils</a> have been shown to have anti-microbial properties.<sup id="cite_ref-134" class="reference"><a href="#cite_note-134"><span class="cite-bracket">&#91;</span>134<span class="cite-bracket">&#93;</span></a></sup> Along with this, the plants from which these oils have been derived from can be used as niche anti-microbial agents.<sup id="cite_ref-135" class="reference"><a href="#cite_note-135"><span class="cite-bracket">&#91;</span>135<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Synthetic_antibiotics_derived_from_dyes">Synthetic antibiotics derived from dyes</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Antibiotic&amp;action=edit&amp;section=17" title="Edit section: Synthetic antibiotics derived from dyes"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size mw-halign-right" typeof="mw:File/Thumb"><a href="/wiki/File:Salvarsan-montage.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/3/36/Salvarsan-montage.png/200px-Salvarsan-montage.png" decoding="async" width="200" height="243" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/3/36/Salvarsan-montage.png/300px-Salvarsan-montage.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/3/36/Salvarsan-montage.png/400px-Salvarsan-montage.png 2x" data-file-width="1809" data-file-height="2200" /></a><figcaption>Arsphenamine, also known as salvarsan, discovered in 1907 by Paul Ehrlich.</figcaption></figure> <p>Synthetic antibiotic chemotherapy as a science and development of antibacterials began in Germany with <a href="/wiki/Paul_Ehrlich" title="Paul Ehrlich">Paul Ehrlich</a> in the late 1880s.<sup id="cite_ref-CALDERIN2007_8-4" class="reference"><a href="#cite_note-CALDERIN2007-8"><span class="cite-bracket">&#91;</span>8<span class="cite-bracket">&#93;</span></a></sup> Ehrlich noted certain dyes would colour human, animal, or bacterial cells, whereas others did not. He then proposed the idea that it might be possible to create chemicals that would act as a selective drug that would bind to and kill bacteria without harming the human host. After screening hundreds of dyes against various organisms, in 1907, he discovered a medicinally useful drug, the first synthetic antibacterial <a href="/wiki/Organoarsenic_chemistry" title="Organoarsenic chemistry">organoarsenic compound</a> <a href="/wiki/Salvarsan" class="mw-redirect" title="Salvarsan">salvarsan</a>,<sup id="cite_ref-CALDERIN2007_8-5" class="reference"><a href="#cite_note-CALDERIN2007-8"><span class="cite-bracket">&#91;</span>8<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-Limbird2004_132-1" class="reference"><a href="#cite_note-Limbird2004-132"><span class="cite-bracket">&#91;</span>132<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-Bosch2008_11-2" class="reference"><a href="#cite_note-Bosch2008-11"><span class="cite-bracket">&#91;</span>11<span class="cite-bracket">&#93;</span></a></sup> now called arsphenamine. </p> <figure class="mw-default-size mw-halign-left" typeof="mw:File/Thumb"><a href="/wiki/File:Paul_Ehrlich_and_Sahachiro_Hata.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/3/3c/Paul_Ehrlich_and_Sahachiro_Hata.jpg/220px-Paul_Ehrlich_and_Sahachiro_Hata.jpg" decoding="async" width="220" height="275" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/3/3c/Paul_Ehrlich_and_Sahachiro_Hata.jpg/330px-Paul_Ehrlich_and_Sahachiro_Hata.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/3/3c/Paul_Ehrlich_and_Sahachiro_Hata.jpg/440px-Paul_Ehrlich_and_Sahachiro_Hata.jpg 2x" data-file-width="2909" data-file-height="3630" /></a><figcaption><a href="/wiki/Paul_Ehrlich" title="Paul Ehrlich">Paul Ehrlich</a> and <a href="/wiki/Sahachiro_Hata" title="Sahachiro Hata">Sahachiro Hata</a> </figcaption></figure> <p>This heralded the era of antibacterial treatment that was begun with the discovery of a series of arsenic-derived synthetic antibiotics by both <a href="/wiki/Alfred_Bertheim" title="Alfred Bertheim">Alfred Bertheim</a> and Ehrlich in 1907.<sup id="cite_ref-ReferenceB_133-1" class="reference"><a href="#cite_note-ReferenceB-133"><span class="cite-bracket">&#91;</span>133<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-goodman_9-2" class="reference"><a href="#cite_note-goodman-9"><span class="cite-bracket">&#91;</span>9<span class="cite-bracket">&#93;</span></a></sup> Ehrlich and Bertheim had experimented with various chemicals derived from dyes to treat <a href="/wiki/Trypanosomiasis" title="Trypanosomiasis">trypanosomiasis</a> in mice and <a href="/wiki/Spirochaeta" title="Spirochaeta">spirochaeta</a> infection in rabbits. While their early compounds were too toxic, Ehrlich and <a href="/wiki/Sahachiro_Hata" title="Sahachiro Hata">Sahachiro Hata</a>, a Japanese bacteriologist working with Ehrlich in the quest for a drug to treat <a href="/wiki/Syphilis" title="Syphilis">syphilis</a>, achieved success with the 606th compound in their series of experiments. In 1910, Ehrlich and Hata announced their discovery, which they called drug "606", at the Congress for Internal Medicine at <a href="/wiki/Wiesbaden" title="Wiesbaden">Wiesbaden</a>.<sup id="cite_ref-jmvh.org_136-0" class="reference"><a href="#cite_note-jmvh.org-136"><span class="cite-bracket">&#91;</span>136<span class="cite-bracket">&#93;</span></a></sup> The <a href="/wiki/Hoechst_AG" title="Hoechst AG">Hoechst</a> company began to market the compound toward the end of 1910 under the name Salvarsan, now known as <a href="/wiki/Arsphenamine" title="Arsphenamine">arsphenamine</a>.<sup id="cite_ref-jmvh.org_136-1" class="reference"><a href="#cite_note-jmvh.org-136"><span class="cite-bracket">&#91;</span>136<span class="cite-bracket">&#93;</span></a></sup> The drug was used to treat syphilis in the first half of the 20th century. In 1908, Ehrlich received the <a href="/wiki/Nobel_Prize_in_Physiology_or_Medicine" title="Nobel Prize in Physiology or Medicine">Nobel Prize in Physiology or Medicine</a> for his contributions to <a href="/wiki/Immunology" title="Immunology">immunology</a>.<sup id="cite_ref-nobel_137-0" class="reference"><a href="#cite_note-nobel-137"><span class="cite-bracket">&#91;</span>137<span class="cite-bracket">&#93;</span></a></sup> Hata was nominated for the <a href="/wiki/Nobel_Prize_in_Chemistry" title="Nobel Prize in Chemistry">Nobel Prize in Chemistry</a> in 1911 and for the Nobel Prize in Physiology or Medicine in 1912 and 1913.<sup id="cite_ref-138" class="reference"><a href="#cite_note-138"><span class="cite-bracket">&#91;</span>138<span class="cite-bracket">&#93;</span></a></sup> </p><p>The first <a href="/wiki/Sulfonamide_(medicine)" title="Sulfonamide (medicine)">sulfonamide</a> and the first <a href="https://en.wiktionary.org/wiki/systemic" class="extiw" title="wikt:systemic">systemically</a> active antibacterial drug, <a href="/wiki/Prontosil" title="Prontosil">Prontosil</a>, was developed by a research team led by <a href="/wiki/Gerhard_Domagk" title="Gerhard Domagk">Gerhard Domagk</a> in 1932 or 1933 at the <a href="/wiki/Bayer" title="Bayer">Bayer</a> Laboratories of the <a href="/wiki/IG_Farben" title="IG Farben">IG Farben</a> conglomerate in Germany,<sup id="cite_ref-goodman_9-3" class="reference"><a href="#cite_note-goodman-9"><span class="cite-bracket">&#91;</span>9<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-ReferenceA_10-1" class="reference"><a href="#cite_note-ReferenceA-10"><span class="cite-bracket">&#91;</span>10<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-Bosch2008_11-3" class="reference"><a href="#cite_note-Bosch2008-11"><span class="cite-bracket">&#91;</span>11<span class="cite-bracket">&#93;</span></a></sup> for which Domagk received the 1939 Nobel Prize in Physiology or Medicine.<sup id="cite_ref-139" class="reference"><a href="#cite_note-139"><span class="cite-bracket">&#91;</span>139<span class="cite-bracket">&#93;</span></a></sup> Sulfanilamide, the active drug of Prontosil, was not patentable as it had already been in use in the dye industry for some years.<sup id="cite_ref-ReferenceA_10-2" class="reference"><a href="#cite_note-ReferenceA-10"><span class="cite-bracket">&#91;</span>10<span class="cite-bracket">&#93;</span></a></sup> Prontosil had a relatively broad effect against <a href="/wiki/Gram-positive" class="mw-redirect" title="Gram-positive">Gram-positive</a> <a href="/wiki/Coccus" class="mw-redirect" title="Coccus">cocci</a>, but not against <a href="/wiki/Enterobacteriaceae" title="Enterobacteriaceae">enterobacteria</a>. Research was stimulated apace by its success. The discovery and development of this sulfonamide <a href="/wiki/Drug" title="Drug">drug</a> opened the era of antibacterials.<sup id="cite_ref-140" class="reference"><a href="#cite_note-140"><span class="cite-bracket">&#91;</span>140<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-141" class="reference"><a href="#cite_note-141"><span class="cite-bracket">&#91;</span>141<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Penicillin_and_other_natural_antibiotics">Penicillin and other natural antibiotics</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Antibiotic&amp;action=edit&amp;section=18" title="Edit section: Penicillin and other natural antibiotics"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">See also: <a href="/wiki/History_of_penicillin" title="History of penicillin">History of penicillin</a></div> <figure class="mw-default-size skin-invert-image" typeof="mw:File/Thumb"><a href="/wiki/File:Penicillin_core.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/9/99/Penicillin_core.svg/170px-Penicillin_core.svg.png" decoding="async" width="170" height="114" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/9/99/Penicillin_core.svg/255px-Penicillin_core.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/9/99/Penicillin_core.svg/340px-Penicillin_core.svg.png 2x" data-file-width="512" data-file-height="342" /></a><figcaption><a href="/wiki/Penicillin" title="Penicillin">Penicillin</a>, discovered by <a href="/wiki/Alexander_Fleming" title="Alexander Fleming">Alexander Fleming</a> in 1928</figcaption></figure> <p>Observations about the growth of some microorganisms inhibiting the growth of other microorganisms have been reported since the late 19th century. These observations of antibiosis between microorganisms led to the discovery of natural antibacterials. <a href="/wiki/Louis_Pasteur" title="Louis Pasteur">Louis Pasteur</a> observed, "if we could intervene in the antagonism observed between some bacteria, it would offer perhaps the greatest hopes for therapeutics".<sup id="cite_ref-Kingston2008_142-0" class="reference"><a href="#cite_note-Kingston2008-142"><span class="cite-bracket">&#91;</span>142<span class="cite-bracket">&#93;</span></a></sup> </p><p>In 1874, physician Sir <a href="/wiki/William_Roberts_(physician)" title="William Roberts (physician)">William Roberts</a> noted that cultures of the mould <i><a href="/wiki/Penicillium_glaucum" title="Penicillium glaucum">Penicillium glaucum</a></i> that is used in the making of some types of <a href="/wiki/Blue_cheese" title="Blue cheese">blue cheese</a> did not display bacterial contamination.<sup id="cite_ref-143" class="reference"><a href="#cite_note-143"><span class="cite-bracket">&#91;</span>143<span class="cite-bracket">&#93;</span></a></sup> </p><p>In 1895 <a href="/wiki/Vincenzo_Tiberio" title="Vincenzo Tiberio">Vincenzo Tiberio</a>, Italian physician, published a paper on the antibacterial power of some extracts of mold.<sup id="cite_ref-144" class="reference"><a href="#cite_note-144"><span class="cite-bracket">&#91;</span>144<span class="cite-bracket">&#93;</span></a></sup> </p><p>In 1897, doctoral student <a href="/wiki/Ernest_Duchesne" title="Ernest Duchesne">Ernest Duchesne</a> submitted a dissertation, "<span title="French-language text"><i lang="fr">Contribution à l'étude de la concurrence vitale chez les micro-organismes: antagonisme entre les moisissures et les microbes</i></span>" (Contribution to the study of vital competition in micro-organisms: antagonism between moulds and microbes),<sup id="cite_ref-145" class="reference"><a href="#cite_note-145"><span class="cite-bracket">&#91;</span>145<span class="cite-bracket">&#93;</span></a></sup> the first known scholarly work to consider the therapeutic capabilities of moulds resulting from their anti-microbial activity. In his thesis, Duchesne proposed that bacteria and moulds engage in a perpetual battle for survival. Duchesne observed that <i><a href="/wiki/Escherichia_coli" title="Escherichia coli">E. coli</a></i> was eliminated by <i>Penicillium glaucum</i> when they were both grown in the same culture. He also observed that when he <a href="/wiki/Inoculation" title="Inoculation">inoculated</a> laboratory animals with lethal doses of <a href="/wiki/Typhoid" class="mw-redirect" title="Typhoid">typhoid</a> bacilli together with <i>Penicillium glaucum</i>, the animals did not contract typhoid. Duchesne's army service after getting his degree prevented him from doing any further research.<sup id="cite_ref-Academic_Press_146-0" class="reference"><a href="#cite_note-Academic_Press-146"><span class="cite-bracket">&#91;</span>146<span class="cite-bracket">&#93;</span></a></sup> Duchesne died of <a href="/wiki/Tuberculosis" title="Tuberculosis">tuberculosis</a>, a disease now treated by antibiotics.<sup id="cite_ref-Academic_Press_146-1" class="reference"><a href="#cite_note-Academic_Press-146"><span class="cite-bracket">&#91;</span>146<span class="cite-bracket">&#93;</span></a></sup> </p><p>In 1928, Sir <a href="/wiki/Alexander_Fleming" title="Alexander Fleming">Alexander Fleming</a> postulated the existence of <a href="/wiki/Penicillin" title="Penicillin">penicillin</a>, a molecule produced by certain moulds that kills or stops the growth of certain kinds of bacteria. Fleming was working on a culture of <a href="/wiki/Pathogen" title="Pathogen">disease-causing</a> bacteria when he noticed the <a href="/wiki/Spore" title="Spore">spores</a> of a green mold, <i><a href="/wiki/Penicillium_rubens" title="Penicillium rubens">Penicillium rubens</a></i>,<sup id="cite_ref-pmid32973216_147-0" class="reference"><a href="#cite_note-pmid32973216-147"><span class="cite-bracket">&#91;</span>147<span class="cite-bracket">&#93;</span></a></sup> in one of his <a href="/wiki/Agar_plate" title="Agar plate">culture plates</a>. He observed that the presence of the mould killed or prevented the growth of the bacteria.<sup id="cite_ref-148" class="reference"><a href="#cite_note-148"><span class="cite-bracket">&#91;</span>148<span class="cite-bracket">&#93;</span></a></sup> Fleming postulated that the mould must secrete an antibacterial substance, which he named penicillin in 1928. Fleming believed that its antibacterial properties could be exploited for chemotherapy. He initially characterised some of its biological properties, and attempted to use a crude preparation to treat some infections, but he was unable to pursue its further development without the aid of trained chemists.<sup id="cite_ref-Fleming1929_149-0" class="reference"><a href="#cite_note-Fleming1929-149"><span class="cite-bracket">&#91;</span>149<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-Sykes2001_150-0" class="reference"><a href="#cite_note-Sykes2001-150"><span class="cite-bracket">&#91;</span>150<span class="cite-bracket">&#93;</span></a></sup> </p><p><a href="/wiki/Ernst_Chain" title="Ernst Chain">Ernst Chain</a>, <a href="/wiki/Howard_Florey" title="Howard Florey">Howard Florey</a> and <a href="/wiki/Edward_Abraham" title="Edward Abraham">Edward Abraham</a> succeeded in purifying the first penicillin, <a href="/wiki/Penicillin_G" class="mw-redirect" title="Penicillin G">penicillin G</a>, in 1942, but it did not become widely available outside the Allied military before 1945. Later, <a href="/wiki/Norman_Heatley" title="Norman Heatley">Norman Heatley</a> developed the back extraction technique for efficiently purifying penicillin in bulk. The chemical structure of penicillin was first proposed by Abraham in 1942<sup id="cite_ref-151" class="reference"><a href="#cite_note-151"><span class="cite-bracket">&#91;</span>151<span class="cite-bracket">&#93;</span></a></sup> and then later confirmed by <a href="/wiki/Dorothy_Crowfoot_Hodgkin" class="mw-redirect" title="Dorothy Crowfoot Hodgkin">Dorothy Crowfoot Hodgkin</a> in 1945. Purified penicillin displayed potent antibacterial activity against a wide range of bacteria and had low toxicity in humans. Furthermore, its activity was not inhibited by biological constituents such as pus, unlike the synthetic <a href="/wiki/Sulfonamides" class="mw-redirect" title="Sulfonamides">sulfonamides</a>. (see below) The development of penicillin led to renewed interest in the search for antibiotic compounds with similar efficacy and safety.<sup id="cite_ref-Use_of_Micro-organisms_for_therapeutic_purposes_152-0" class="reference"><a href="#cite_note-Use_of_Micro-organisms_for_therapeutic_purposes-152"><span class="cite-bracket">&#91;</span>152<span class="cite-bracket">&#93;</span></a></sup> For their successful development of penicillin, which Fleming had accidentally discovered but could not develop himself, as a therapeutic drug, Chain and Florey shared the 1945 <a href="/wiki/Nobel_Prize_in_Medicine" class="mw-redirect" title="Nobel Prize in Medicine">Nobel Prize in Medicine</a> with Fleming.<sup id="cite_ref-153" class="reference"><a href="#cite_note-153"><span class="cite-bracket">&#91;</span>153<span class="cite-bracket">&#93;</span></a></sup> </p><p>Florey credited <a href="/wiki/Ren%C3%A9_Dubos" title="René Dubos">René Dubos</a> with pioneering the approach of deliberately and systematically searching for antibacterial compounds, which had led to the discovery of gramicidin and had revived Florey's research in penicillin.<sup id="cite_ref-Epps2006_154-0" class="reference"><a href="#cite_note-Epps2006-154"><span class="cite-bracket">&#91;</span>154<span class="cite-bracket">&#93;</span></a></sup> In 1939, coinciding with the start of <a href="/wiki/World_War_II" title="World War II">World War II</a>, Dubos had reported the discovery of the first naturally derived antibiotic, <a href="/wiki/Tyrothricin" title="Tyrothricin">tyrothricin</a>, a compound of 20% <a href="/wiki/Gramicidin" title="Gramicidin">gramicidin</a> and 80% <a href="/wiki/Tyrocidine" title="Tyrocidine">tyrocidine</a>, from <i>Bacillus brevis</i>. It was one of the first commercially manufactured antibiotics and was very effective in treating wounds and ulcers during World War II.<sup id="cite_ref-Epps2006_154-1" class="reference"><a href="#cite_note-Epps2006-154"><span class="cite-bracket">&#91;</span>154<span class="cite-bracket">&#93;</span></a></sup> Gramicidin, however, could not be used systemically because of toxicity. Tyrocidine also proved too toxic for systemic usage. Research results obtained during that period were not shared between the <a href="/wiki/Axis_powers" title="Axis powers">Axis</a> and the <a href="/wiki/Allied_powers_of_World_War_II" class="mw-redirect" title="Allied powers of World War II">Allied powers</a> during World War II and limited access during the <a href="/wiki/Cold_War" title="Cold War">Cold War</a>.<sup id="cite_ref-155" class="reference"><a href="#cite_note-155"><span class="cite-bracket">&#91;</span>155<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Late_20th_century">Late 20th century</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Antibiotic&amp;action=edit&amp;section=19" title="Edit section: Late 20th century"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>During the mid-20th century, the number of new antibiotic substances introduced for medical use increased significantly. From 1935 to 1968, 12 new classes were launched. However, after this, the number of new classes dropped markedly, with only two new classes introduced between 1969 and 2003.<sup id="cite_ref-156" class="reference"><a href="#cite_note-156"><span class="cite-bracket">&#91;</span>156<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Antibiotic_pipeline">Antibiotic pipeline</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Antibiotic&amp;action=edit&amp;section=20" title="Edit section: Antibiotic pipeline"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Both the WHO and the <a href="/wiki/Infectious_Disease_Society_of_America" class="mw-redirect" title="Infectious Disease Society of America">Infectious Disease Society of America</a> report that the weak antibiotic pipeline does not match bacteria's increasing ability to develop resistance.<sup id="cite_ref-WHO_-_analysis_of_pipeline_157-0" class="reference"><a href="#cite_note-WHO_-_analysis_of_pipeline-157"><span class="cite-bracket">&#91;</span>157<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-158" class="reference"><a href="#cite_note-158"><span class="cite-bracket">&#91;</span>158<span class="cite-bracket">&#93;</span></a></sup> The Infectious Disease Society of America report noted that the number of new antibiotics approved for marketing per year had been declining and identified seven antibiotics against the <a href="/wiki/Gram-negative_bacilli" class="mw-redirect" title="Gram-negative bacilli">Gram-negative bacilli</a> currently in <a href="/wiki/Phases_of_clinical_research#Phase_II" title="Phases of clinical research">phase 2</a> or <a href="/wiki/Phases_of_clinical_research#Phase_III" title="Phases of clinical research">phase 3</a> clinical trials. However, these drugs did not address the entire spectrum of resistance of Gram-negative bacilli.<sup id="cite_ref-159" class="reference"><a href="#cite_note-159"><span class="cite-bracket">&#91;</span>159<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-IDSA2013_160-0" class="reference"><a href="#cite_note-IDSA2013-160"><span class="cite-bracket">&#91;</span>160<span class="cite-bracket">&#93;</span></a></sup> According to the WHO fifty one new therapeutic entities - antibiotics (including combinations), are in phase 1-3 clinical trials as of May 2017.<sup id="cite_ref-WHO_-_analysis_of_pipeline_157-1" class="reference"><a href="#cite_note-WHO_-_analysis_of_pipeline-157"><span class="cite-bracket">&#91;</span>157<span class="cite-bracket">&#93;</span></a></sup> Antibiotics targeting multidrug-resistant Gram-positive pathogens remains a high priority.<sup id="cite_ref-161" class="reference"><a href="#cite_note-161"><span class="cite-bracket">&#91;</span>161<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-WHO_-_analysis_of_pipeline_157-2" class="reference"><a href="#cite_note-WHO_-_analysis_of_pipeline-157"><span class="cite-bracket">&#91;</span>157<span class="cite-bracket">&#93;</span></a></sup> </p><p>A few antibiotics have received marketing authorization in the last seven years. The cephalosporin ceftaroline and the lipoglycopeptides oritavancin and telavancin have been approved for the treatment of acute bacterial skin and skin structure infection and community-acquired bacterial pneumonia.<sup id="cite_ref-Fernandes,_Martens_162-0" class="reference"><a href="#cite_note-Fernandes,_Martens-162"><span class="cite-bracket">&#91;</span>162<span class="cite-bracket">&#93;</span></a></sup> The lipoglycopeptide dalbavancin and the oxazolidinone tedizolid has also been approved for use for the treatment of acute bacterial skin and skin structure infection. The first in a new class of narrow-spectrum <a href="/wiki/Macrocycle" title="Macrocycle">macrocyclic</a> antibiotics, fidaxomicin, has been approved for the treatment of <i>C. difficile</i> colitis.<sup id="cite_ref-Fernandes,_Martens_162-1" class="reference"><a href="#cite_note-Fernandes,_Martens-162"><span class="cite-bracket">&#91;</span>162<span class="cite-bracket">&#93;</span></a></sup> New cephalosporin-lactamase inhibitor combinations also approved include ceftazidime-avibactam and ceftolozane-avibactam for complicated urinary tract infection and intra-abdominal infection.<sup id="cite_ref-Fernandes,_Martens_162-2" class="reference"><a href="#cite_note-Fernandes,_Martens-162"><span class="cite-bracket">&#91;</span>162<span class="cite-bracket">&#93;</span></a></sup> </p> <style data-mw-deduplicate="TemplateStyles:r1184024115">.mw-parser-output .div-col{margin-top:0.3em;column-width:30em}.mw-parser-output .div-col-small{font-size:90%}.mw-parser-output .div-col-rules{column-rule:1px solid #aaa}.mw-parser-output .div-col dl,.mw-parser-output .div-col ol,.mw-parser-output .div-col ul{margin-top:0}.mw-parser-output .div-col li,.mw-parser-output .div-col dd{page-break-inside:avoid;break-inside:avoid-column}</style><div class="div-col" style="column-width: 30em;"> <ul><li><a href="/wiki/Ceftolozane" class="mw-redirect" title="Ceftolozane">Ceftolozane</a>/<a href="/wiki/Tazobactam" title="Tazobactam">tazobactam</a> (CXA-201; CXA-101/tazobactam): <a href="/wiki/Antipseudomonal" class="mw-redirect" title="Antipseudomonal">Antipseudomonal</a> <a href="/wiki/Cephalosporin" title="Cephalosporin">cephalosporin</a>/<a href="/wiki/%CE%92-lactamase" class="mw-redirect" title="Β-lactamase">β-lactamase</a> inhibitor combination (cell wall synthesis inhibitor). FDA approved on 19 December 2014.<sup id="cite_ref-163" class="reference"><a href="#cite_note-163"><span class="cite-bracket">&#91;</span>163<span class="cite-bracket">&#93;</span></a></sup></li> <li><a href="/wiki/Ceftazidime" title="Ceftazidime">Ceftazidime</a>/<a href="/wiki/Avibactam" title="Avibactam">avibactam</a> (ceftazidime/NXL104): antipseudomonal cephalosporin/β-lactamase inhibitor combination (cell wall synthesis inhibitor).<sup id="cite_ref-pmid32152527_164-0" class="reference"><a href="#cite_note-pmid32152527-164"><span class="cite-bracket">&#91;</span>164<span class="cite-bracket">&#93;</span></a></sup> FDA approved on 25 February 2015.</li> <li><a href="/wiki/Ceftaroline" class="mw-redirect" title="Ceftaroline">Ceftaroline</a>/avibactam (CPT-avibactam; ceftaroline/NXL104): Anti-<a href="/wiki/MRSA" class="mw-redirect" title="MRSA">MRSA</a> cephalosporin/ β-lactamase inhibitor combination (cell wall synthesis inhibitor).<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">&#91;<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (August 2024)">citation needed</span></a></i>&#93;</sup></li> <li><a href="/wiki/Cefiderocol" title="Cefiderocol">Cefiderocol</a>: <a href="/wiki/Cephalosporin" title="Cephalosporin">cephalosporin</a> siderophore.<sup id="cite_ref-pmid32152527_164-1" class="reference"><a href="#cite_note-pmid32152527-164"><span class="cite-bracket">&#91;</span>164<span class="cite-bracket">&#93;</span></a></sup> FDA approved on 14 November 2019.</li> <li><a href="/wiki/Imipenem" title="Imipenem">Imipenem</a>/relebactam: <a href="/wiki/Carbapenem" title="Carbapenem">carbapenem</a>/ β-lactamase inhibitor combination (cell wall synthesis inhibitor).<sup id="cite_ref-pmid32152527_164-2" class="reference"><a href="#cite_note-pmid32152527-164"><span class="cite-bracket">&#91;</span>164<span class="cite-bracket">&#93;</span></a></sup> FDA approved on 16 July 2019.</li> <li><a href="/wiki/Meropenem/vaborbactam" title="Meropenem/vaborbactam">Meropenem/vaborbactam</a>: <a href="/wiki/Carbapenem" title="Carbapenem">carbapenem</a>/ β-lactamase inhibitor combination (cell wall synthesis inhibitor).<sup id="cite_ref-pmid32152527_164-3" class="reference"><a href="#cite_note-pmid32152527-164"><span class="cite-bracket">&#91;</span>164<span class="cite-bracket">&#93;</span></a></sup> FDA approved on 29 August 2017.</li> <li><a href="/wiki/Delafloxacin" title="Delafloxacin">Delafloxacin</a>: <a href="/wiki/Quinolone" title="Quinolone">quinolone</a> (inhibitor of DNA synthesis).<sup id="cite_ref-pmid32152527_164-4" class="reference"><a href="#cite_note-pmid32152527-164"><span class="cite-bracket">&#91;</span>164<span class="cite-bracket">&#93;</span></a></sup> FDA approved on 19 June 2017.</li> <li><a href="/wiki/Plazomicin" title="Plazomicin">Plazomicin</a> (ACHN-490): semi-synthetic <a href="/wiki/Aminoglycoside" title="Aminoglycoside">aminoglycoside</a> derivative (<a href="/wiki/Protein_synthesis_inhibitor" title="Protein synthesis inhibitor">protein synthesis inhibitor</a>).<sup id="cite_ref-pmid32152527_164-5" class="reference"><a href="#cite_note-pmid32152527-164"><span class="cite-bracket">&#91;</span>164<span class="cite-bracket">&#93;</span></a></sup> FDA approved 25 June 2018.</li> <li><a href="/wiki/Eravacycline" title="Eravacycline">Eravacycline</a> (TP-434): synthetic <a href="/wiki/Tetracycline" title="Tetracycline">tetracycline</a> derivative (protein synthesis inhibitor targeting bacterial ribosomes).<sup id="cite_ref-pmid32152527_164-6" class="reference"><a href="#cite_note-pmid32152527-164"><span class="cite-bracket">&#91;</span>164<span class="cite-bracket">&#93;</span></a></sup> FDA approved on 27 August 2018.</li> <li><a href="/wiki/Omadacycline" title="Omadacycline">Omadacycline</a>: semi-synthetic <a href="/wiki/Tetracycline" title="Tetracycline">tetracycline</a> derivative (protein synthesis inhibitor targeting bacterial ribosomes).<sup id="cite_ref-pmid32152527_164-7" class="reference"><a href="#cite_note-pmid32152527-164"><span class="cite-bracket">&#91;</span>164<span class="cite-bracket">&#93;</span></a></sup> FDA approved on 2 October 2018.</li> <li><a href="/wiki/Lefamulin" title="Lefamulin">Lefamulin</a>: pleuromutilin antibiotic.<sup id="cite_ref-pmid32152527_164-8" class="reference"><a href="#cite_note-pmid32152527-164"><span class="cite-bracket">&#91;</span>164<span class="cite-bracket">&#93;</span></a></sup> FDA approved on 19 August 2019.</li> <li><a href="/wiki/Brilacidin" title="Brilacidin">Brilacidin</a> (PMX-30063): peptide defense protein mimetic (cell membrane disruption). In phase 2.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">&#91;<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (August 2024)">citation needed</span></a></i>&#93;</sup></li> <li><a href="/wiki/Zosurabalpin" title="Zosurabalpin">Zosurabalpin</a> (RG-6006): lipopolysaccharide transport inhibitor. In phase 1.<sup id="cite_ref-165" class="reference"><a href="#cite_note-165"><span class="cite-bracket">&#91;</span>165<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-166" class="reference"><a href="#cite_note-166"><span class="cite-bracket">&#91;</span>166<span class="cite-bracket">&#93;</span></a></sup></li></ul></div> <p>Possible improvements include clarification of clinical trial regulations by FDA. Furthermore, appropriate economic incentives could persuade pharmaceutical companies to invest in this endeavor.<sup id="cite_ref-IDSA2013_160-1" class="reference"><a href="#cite_note-IDSA2013-160"><span class="cite-bracket">&#91;</span>160<span class="cite-bracket">&#93;</span></a></sup> In the US, the <a href="/wiki/Antibiotic_Development_to_Advance_Patient_Treatment" class="mw-redirect" title="Antibiotic Development to Advance Patient Treatment">Antibiotic Development to Advance Patient Treatment</a> (ADAPT) Act was introduced with the aim of fast tracking the <a href="/wiki/Drug_development" title="Drug development">drug development</a> of antibiotics to combat the growing threat of 'superbugs'. Under this Act, FDA can approve antibiotics and antifungals treating life-threatening infections based on smaller clinical trials. The <a href="/wiki/Centers_for_Disease_Control_and_Prevention" title="Centers for Disease Control and Prevention">CDC</a> will monitor the use of antibiotics and the emerging resistance, and publish the data. The FDA antibiotics labeling process, 'Susceptibility Test Interpretive Criteria for Microbial Organisms' or 'breakpoints', will provide accurate data to healthcare professionals.<sup id="cite_ref-167" class="reference"><a href="#cite_note-167"><span class="cite-bracket">&#91;</span>167<span class="cite-bracket">&#93;</span></a></sup> According to Allan Coukell, senior director for health programs at The Pew Charitable Trusts, "By allowing drug developers to rely on smaller datasets, and clarifying FDA's authority to tolerate a higher level of uncertainty for these drugs when making a risk/benefit calculation, ADAPT would make the clinical trials more feasible."<sup id="cite_ref-168" class="reference"><a href="#cite_note-168"><span class="cite-bracket">&#91;</span>168<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Replenishing_the_antibiotic_pipeline_and_developing_other_new_therapies">Replenishing the antibiotic pipeline and developing other new therapies</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Antibiotic&amp;action=edit&amp;section=21" title="Edit section: Replenishing the antibiotic pipeline and developing other new therapies"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Because antibiotic-resistant bacterial strains continue to emerge and spread, there is a constant need to develop new antibacterial treatments. Current strategies include traditional chemistry-based approaches such as <a href="/wiki/Natural_product" title="Natural product">natural product</a>-based <a href="/wiki/Drug_discovery" title="Drug discovery">drug discovery</a>,<sup id="cite_ref-Natural_Products_169-0" class="reference"><a href="#cite_note-Natural_Products-169"><span class="cite-bracket">&#91;</span>169<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-pmid32529587_170-0" class="reference"><a href="#cite_note-pmid32529587-170"><span class="cite-bracket">&#91;</span>170<span class="cite-bracket">&#93;</span></a></sup> newer chemistry-based approaches such as <a href="/wiki/Drug_design" title="Drug design">drug design</a>,<sup id="cite_ref-pmid32199982_171-0" class="reference"><a href="#cite_note-pmid32199982-171"><span class="cite-bracket">&#91;</span>171<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-pmid30360704_172-0" class="reference"><a href="#cite_note-pmid30360704-172"><span class="cite-bracket">&#91;</span>172<span class="cite-bracket">&#93;</span></a></sup> traditional biology-based approaches such as <a href="/wiki/Immunoglobulin_therapy" title="Immunoglobulin therapy">immunoglobulin therapy</a>,<sup id="cite_ref-pmid31295426_173-0" class="reference"><a href="#cite_note-pmid31295426-173"><span class="cite-bracket">&#91;</span>173<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-pmid30683453_174-0" class="reference"><a href="#cite_note-pmid30683453-174"><span class="cite-bracket">&#91;</span>174<span class="cite-bracket">&#93;</span></a></sup> and experimental biology-based approaches such as <a href="/wiki/Phage_therapy" title="Phage therapy">phage therapy</a>,<sup id="cite_ref-175" class="reference"><a href="#cite_note-175"><span class="cite-bracket">&#91;</span>175<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-pmid26795692_176-0" class="reference"><a href="#cite_note-pmid26795692-176"><span class="cite-bracket">&#91;</span>176<span class="cite-bracket">&#93;</span></a></sup> <a href="/wiki/Fecal_microbiota_transplant" title="Fecal microbiota transplant">fecal microbiota transplants</a>,<sup id="cite_ref-pmid31295426_173-1" class="reference"><a href="#cite_note-pmid31295426-173"><span class="cite-bracket">&#91;</span>173<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-177" class="reference"><a href="#cite_note-177"><span class="cite-bracket">&#91;</span>177<span class="cite-bracket">&#93;</span></a></sup> <a href="/wiki/Antisense_RNA" title="Antisense RNA">antisense RNA</a>-based treatments,<sup id="cite_ref-pmid31295426_173-2" class="reference"><a href="#cite_note-pmid31295426-173"><span class="cite-bracket">&#91;</span>173<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-pmid30683453_174-1" class="reference"><a href="#cite_note-pmid30683453-174"><span class="cite-bracket">&#91;</span>174<span class="cite-bracket">&#93;</span></a></sup> and <a href="/wiki/CRISPR" title="CRISPR">CRISPR-Cas9</a>-based treatments.<sup id="cite_ref-pmid31295426_173-3" class="reference"><a href="#cite_note-pmid31295426-173"><span class="cite-bracket">&#91;</span>173<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-pmid30683453_174-2" class="reference"><a href="#cite_note-pmid30683453-174"><span class="cite-bracket">&#91;</span>174<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-pmid32575913_178-0" class="reference"><a href="#cite_note-pmid32575913-178"><span class="cite-bracket">&#91;</span>178<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Natural_product-based_antibiotic_discovery">Natural product-based antibiotic discovery</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Antibiotic&amp;action=edit&amp;section=22" title="Edit section: Natural product-based antibiotic discovery"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">See also: <a href="/wiki/Bioprospecting" title="Bioprospecting">Bioprospecting</a></div> <style data-mw-deduplicate="TemplateStyles:r1237032888/mw-parser-output/.tmulti">.mw-parser-output .tmulti .multiimageinner{display:flex;flex-direction:column}.mw-parser-output .tmulti .trow{display:flex;flex-direction:row;clear:left;flex-wrap:wrap;width:100%;box-sizing:border-box}.mw-parser-output .tmulti .tsingle{margin:1px;float:left}.mw-parser-output .tmulti .theader{clear:both;font-weight:bold;text-align:center;align-self:center;background-color:transparent;width:100%}.mw-parser-output .tmulti .thumbcaption{background-color:transparent}.mw-parser-output .tmulti .text-align-left{text-align:left}.mw-parser-output .tmulti .text-align-right{text-align:right}.mw-parser-output .tmulti .text-align-center{text-align:center}@media all and (max-width:720px){.mw-parser-output .tmulti .thumbinner{width:100%!important;box-sizing:border-box;max-width:none!important;align-items:center}.mw-parser-output .tmulti .trow{justify-content:center}.mw-parser-output .tmulti .tsingle{float:none!important;max-width:100%!important;box-sizing:border-box;text-align:center}.mw-parser-output .tmulti .tsingle .thumbcaption{text-align:left}.mw-parser-output .tmulti .trow>.thumbcaption{text-align:center}}@media screen{html.skin-theme-clientpref-night .mw-parser-output .tmulti .multiimageinner img{background-color:white}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .tmulti .multiimageinner img{background-color:white}}</style><div class="thumb tmulti tright"><div class="thumbinner multiimageinner" style="width:267px;max-width:267px"><div class="trow"><div class="tsingle" style="width:131px;max-width:131px"><div class="thumbimage" style="height:86px;overflow:hidden"><span typeof="mw:File"><a href="/wiki/File:Streptomyces_sp_01.png" class="mw-file-description"><img alt="" src="//upload.wikimedia.org/wikipedia/commons/thumb/d/de/Streptomyces_sp_01.png/129px-Streptomyces_sp_01.png" decoding="async" width="129" height="86" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/d/de/Streptomyces_sp_01.png/194px-Streptomyces_sp_01.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/d/de/Streptomyces_sp_01.png/258px-Streptomyces_sp_01.png 2x" data-file-width="734" data-file-height="490" /></a></span></div></div><div class="tsingle" style="width:132px;max-width:132px"><div class="thumbimage" style="height:86px;overflow:hidden"><span typeof="mw:File"><a href="/wiki/File:Acremonium_falciforme_PHIL_4167_lores.jpg" class="mw-file-description"><img alt="" src="//upload.wikimedia.org/wikipedia/commons/thumb/a/a3/Acremonium_falciforme_PHIL_4167_lores.jpg/130px-Acremonium_falciforme_PHIL_4167_lores.jpg" decoding="async" width="130" height="87" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/a/a3/Acremonium_falciforme_PHIL_4167_lores.jpg/195px-Acremonium_falciforme_PHIL_4167_lores.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/a/a3/Acremonium_falciforme_PHIL_4167_lores.jpg/260px-Acremonium_falciforme_PHIL_4167_lores.jpg 2x" data-file-width="700" data-file-height="466" /></a></span></div></div></div><div class="trow"><div class="tsingle" style="width:130px;max-width:130px"><div class="thumbimage" style="height:95px;overflow:hidden"><span typeof="mw:File"><a href="/wiki/File:Hydrastis.jpg" class="mw-file-description"><img alt="" src="//upload.wikimedia.org/wikipedia/commons/thumb/5/52/Hydrastis.jpg/128px-Hydrastis.jpg" decoding="async" width="128" height="96" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/5/52/Hydrastis.jpg/192px-Hydrastis.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/5/52/Hydrastis.jpg/256px-Hydrastis.jpg 2x" data-file-width="2848" data-file-height="2136" /></a></span></div></div><div class="tsingle" style="width:133px;max-width:133px"><div class="thumbimage" style="height:95px;overflow:hidden"><span typeof="mw:File"><a href="/wiki/File:Agelas_tubulata_cropped.jpg" class="mw-file-description"><img alt="" src="//upload.wikimedia.org/wikipedia/commons/thumb/5/58/Agelas_tubulata_cropped.jpg/131px-Agelas_tubulata_cropped.jpg" decoding="async" width="131" height="96" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/5/58/Agelas_tubulata_cropped.jpg/197px-Agelas_tubulata_cropped.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/5/58/Agelas_tubulata_cropped.jpg/262px-Agelas_tubulata_cropped.jpg 2x" data-file-width="1630" data-file-height="1194" /></a></span></div></div></div><div class="trow" style="display:flex"><div class="thumbcaption">Bacteria, fungi, plants, animals and other organisms are being screened in the search for new antibiotics.<sup id="cite_ref-pmid32529587_170-1" class="reference"><a href="#cite_note-pmid32529587-170"><span class="cite-bracket">&#91;</span>170<span class="cite-bracket">&#93;</span></a></sup></div></div></div></div> <p>Most of the antibiotics in current use are <a href="/wiki/Natural_product" title="Natural product">natural products</a> or natural product derivatives,<sup id="cite_ref-pmid32529587_170-2" class="reference"><a href="#cite_note-pmid32529587-170"><span class="cite-bracket">&#91;</span>170<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-pmid31733401_179-0" class="reference"><a href="#cite_note-pmid31733401-179"><span class="cite-bracket">&#91;</span>179<span class="cite-bracket">&#93;</span></a></sup> and <a href="/wiki/Bacteria" title="Bacteria">bacterial</a>,<sup id="cite_ref-180" class="reference"><a href="#cite_note-180"><span class="cite-bracket">&#91;</span>180<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-181" class="reference"><a href="#cite_note-181"><span class="cite-bracket">&#91;</span>181<span class="cite-bracket">&#93;</span></a></sup> <a href="/wiki/Fungal" class="mw-redirect" title="Fungal">fungal</a>,<sup id="cite_ref-Natural_Products_169-1" class="reference"><a href="#cite_note-Natural_Products-169"><span class="cite-bracket">&#91;</span>169<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-pmid23978412_182-0" class="reference"><a href="#cite_note-pmid23978412-182"><span class="cite-bracket">&#91;</span>182<span class="cite-bracket">&#93;</span></a></sup> <a href="/wiki/Plant" title="Plant">plant</a><sup id="cite_ref-Kenny,_Furey,_Lucey_183-0" class="reference"><a href="#cite_note-Kenny,_Furey,_Lucey-183"><span class="cite-bracket">&#91;</span>183<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-184" class="reference"><a href="#cite_note-184"><span class="cite-bracket">&#91;</span>184<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-185" class="reference"><a href="#cite_note-185"><span class="cite-bracket">&#91;</span>185<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-Monte_186-0" class="reference"><a href="#cite_note-Monte-186"><span class="cite-bracket">&#91;</span>186<span class="cite-bracket">&#93;</span></a></sup> and <a href="/wiki/Animal" title="Animal">animal</a><sup id="cite_ref-Natural_Products_169-2" class="reference"><a href="#cite_note-Natural_Products-169"><span class="cite-bracket">&#91;</span>169<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-pmid27373625_187-0" class="reference"><a href="#cite_note-pmid27373625-187"><span class="cite-bracket">&#91;</span>187<span class="cite-bracket">&#93;</span></a></sup> extracts are being screened in the search for new antibiotics. Organisms may be selected for testing based on <a href="/wiki/Ecological" class="mw-redirect" title="Ecological">ecological</a>, <a href="/wiki/Ethnomedical" class="mw-redirect" title="Ethnomedical">ethnomedical</a>, <a href="/wiki/Genomic" class="mw-redirect" title="Genomic">genomic</a>, or <a href="/wiki/Historical" class="mw-redirect" title="Historical">historical</a> rationales.<sup id="cite_ref-pmid32529587_170-3" class="reference"><a href="#cite_note-pmid32529587-170"><span class="cite-bracket">&#91;</span>170<span class="cite-bracket">&#93;</span></a></sup> <a href="/wiki/Medicinal_plants" title="Medicinal plants">Medicinal plants</a>, for example, are screened on the basis that they are used by traditional healers to prevent or cure infection and may therefore contain antibacterial compounds.<sup id="cite_ref-cowen_188-0" class="reference"><a href="#cite_note-cowen-188"><span class="cite-bracket">&#91;</span>188<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-Plants_as_sources_189-0" class="reference"><a href="#cite_note-Plants_as_sources-189"><span class="cite-bracket">&#91;</span>189<span class="cite-bracket">&#93;</span></a></sup> Also, soil bacteria are screened on the basis that, historically, they have been a very rich source of antibiotics (with 70 to 80% of antibiotics in current use derived from the <a href="/wiki/Actinomycetes" class="mw-redirect" title="Actinomycetes">actinomycetes</a>).<sup id="cite_ref-pmid32529587_170-4" class="reference"><a href="#cite_note-pmid32529587-170"><span class="cite-bracket">&#91;</span>170<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-pmid27890726_190-0" class="reference"><a href="#cite_note-pmid27890726-190"><span class="cite-bracket">&#91;</span>190<span class="cite-bracket">&#93;</span></a></sup> </p><p>In addition to screening natural products for direct antibacterial activity, they are sometimes screened for the ability to suppress <a href="/wiki/Antimicrobial_resistance" title="Antimicrobial resistance">antibiotic resistance</a> and <a href="/wiki/Antibiotic_tolerance" class="mw-redirect" title="Antibiotic tolerance">antibiotic tolerance</a>.<sup id="cite_ref-Plants_as_sources_189-1" class="reference"><a href="#cite_note-Plants_as_sources-189"><span class="cite-bracket">&#91;</span>189<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-pmid21562562_191-0" class="reference"><a href="#cite_note-pmid21562562-191"><span class="cite-bracket">&#91;</span>191<span class="cite-bracket">&#93;</span></a></sup> For example, some <a href="/wiki/Secondary_metabolites" class="mw-redirect" title="Secondary metabolites">secondary metabolites</a> inhibit <a href="/wiki/Drug_efflux" class="mw-redirect" title="Drug efflux">drug efflux</a> pumps, thereby increasing the concentration of antibiotic able to reach its cellular target and decreasing bacterial resistance to the antibiotic.<sup id="cite_ref-Plants_as_sources_189-2" class="reference"><a href="#cite_note-Plants_as_sources-189"><span class="cite-bracket">&#91;</span>189<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-Efflux_pump_inhibitors_192-0" class="reference"><a href="#cite_note-Efflux_pump_inhibitors-192"><span class="cite-bracket">&#91;</span>192<span class="cite-bracket">&#93;</span></a></sup> Natural products known to inhibit bacterial efflux pumps include the <a href="/wiki/Alkaloid" title="Alkaloid">alkaloid</a> <a href="/wiki/Lysergol" title="Lysergol">lysergol</a>,<sup id="cite_ref-193" class="reference"><a href="#cite_note-193"><span class="cite-bracket">&#91;</span>193<span class="cite-bracket">&#93;</span></a></sup> the <a href="/wiki/Carotenoid" title="Carotenoid">carotenoids</a> <a href="/wiki/Capsanthin" title="Capsanthin">capsanthin</a> and <a href="/wiki/Capsorubin" title="Capsorubin">capsorubin</a>,<sup id="cite_ref-pmid20645919_194-0" class="reference"><a href="#cite_note-pmid20645919-194"><span class="cite-bracket">&#91;</span>194<span class="cite-bracket">&#93;</span></a></sup> and the <a href="/wiki/Flavonoid" title="Flavonoid">flavonoids</a> <a href="/wiki/Rotenone" title="Rotenone">rotenone</a> and <a href="/wiki/Chrysin" title="Chrysin">chrysin</a>.<sup id="cite_ref-pmid20645919_194-1" class="reference"><a href="#cite_note-pmid20645919-194"><span class="cite-bracket">&#91;</span>194<span class="cite-bracket">&#93;</span></a></sup> Other natural products, this time <a href="/wiki/Primary_metabolite" title="Primary metabolite">primary metabolites</a> rather than secondary metabolites, have been shown to eradicate antibiotic tolerance. For example, <a href="/wiki/Glucose" title="Glucose">glucose</a>, <a href="/wiki/Mannitol" title="Mannitol">mannitol</a>, and <a href="/wiki/Fructose" title="Fructose">fructose</a> reduce antibiotic tolerance in <i><a href="/wiki/Escherichia_coli" title="Escherichia coli">Escherichia coli</a></i> and <i><a href="/wiki/Staphylococcus_aureus" title="Staphylococcus aureus">Staphylococcus aureus</a></i>, rendering them more susceptible to killing by <a href="/wiki/Aminoglycoside" title="Aminoglycoside">aminoglycoside</a> antibiotics.<sup id="cite_ref-pmid21562562_191-1" class="reference"><a href="#cite_note-pmid21562562-191"><span class="cite-bracket">&#91;</span>191<span class="cite-bracket">&#93;</span></a></sup> </p><p>Natural products may be screened for the ability to suppress bacterial <a href="/wiki/Virulence_factor" title="Virulence factor">virulence factors</a> too. Virulence factors are molecules, cellular structures and regulatory systems that enable bacteria to evade the body's immune defenses (e.g. <a href="/wiki/Urease" title="Urease">urease</a>, <a href="/wiki/Staphyloxanthin" title="Staphyloxanthin">staphyloxanthin</a>), move towards, attach to, and/or invade human cells (e.g. <a href="/wiki/Type_IV_pili" class="mw-redirect" title="Type IV pili">type IV pili</a>, <a href="/wiki/Bacterial_adhesin" title="Bacterial adhesin">adhesins</a>, <a href="/wiki/Internalin" title="Internalin">internalins</a>), coordinate the activation of virulence genes (e.g. <a href="/wiki/Quorum_sensing" title="Quorum sensing">quorum sensing</a>), and cause disease (e.g. <a href="/wiki/Exotoxin" title="Exotoxin">exotoxins</a>).<sup id="cite_ref-pmid31295426_173-4" class="reference"><a href="#cite_note-pmid31295426-173"><span class="cite-bracket">&#91;</span>173<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-Monte_186-1" class="reference"><a href="#cite_note-Monte-186"><span class="cite-bracket">&#91;</span>186<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-pmid21514796_195-0" class="reference"><a href="#cite_note-pmid21514796-195"><span class="cite-bracket">&#91;</span>195<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-pmid31410034_196-0" class="reference"><a href="#cite_note-pmid31410034-196"><span class="cite-bracket">&#91;</span>196<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-197" class="reference"><a href="#cite_note-197"><span class="cite-bracket">&#91;</span>197<span class="cite-bracket">&#93;</span></a></sup> Examples of natural products with antivirulence activity include the flavonoid <a href="/wiki/Epigallocatechin_gallate" title="Epigallocatechin gallate">epigallocatechin gallate</a> (which inhibits <a href="/wiki/Listeriolysin_O" title="Listeriolysin O">listeriolysin O</a>),<sup id="cite_ref-pmid21514796_195-1" class="reference"><a href="#cite_note-pmid21514796-195"><span class="cite-bracket">&#91;</span>195<span class="cite-bracket">&#93;</span></a></sup> the <a href="/wiki/Quinone" title="Quinone">quinone</a> tetrangomycin (which inhibits staphyloxanthin),<sup id="cite_ref-pmid31410034_196-1" class="reference"><a href="#cite_note-pmid31410034-196"><span class="cite-bracket">&#91;</span>196<span class="cite-bracket">&#93;</span></a></sup> and the <a href="/wiki/Sesquiterpene" title="Sesquiterpene">sesquiterpene</a> zerumbone (which inhibits <i><a href="/wiki/Acinetobacter_baumannii" title="Acinetobacter baumannii">Acinetobacter baumannii</a></i> <a href="/wiki/Bacteria#Movement" title="Bacteria">motility</a>).<sup id="cite_ref-pmid32463353_198-0" class="reference"><a href="#cite_note-pmid32463353-198"><span class="cite-bracket">&#91;</span>198<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Immunoglobulin_therapy">Immunoglobulin therapy</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Antibiotic&amp;action=edit&amp;section=23" title="Edit section: Immunoglobulin therapy"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Monoclonal_antibody_therapy" title="Monoclonal antibody therapy">Monoclonal antibody therapy</a></div> <p>Antibodies (<a href="/wiki/Anti-tetanus_immunoglobulin" title="Anti-tetanus immunoglobulin">anti-tetanus immunoglobulin</a>) have been used in the treatment and prevention of <a href="/wiki/Tetanus" title="Tetanus">tetanus</a> since the 1910s,<sup id="cite_ref-199" class="reference"><a href="#cite_note-199"><span class="cite-bracket">&#91;</span>199<span class="cite-bracket">&#93;</span></a></sup> and this approach continues to be a useful way of controlling bacterial diseases. The <a href="/wiki/Monoclonal_antibody" title="Monoclonal antibody">monoclonal antibody</a> <a href="/wiki/Bezlotoxumab" title="Bezlotoxumab">bezlotoxumab</a>, for example, has been approved by the <a href="/wiki/Food_and_Drug_Administration" title="Food and Drug Administration">US FDA</a> and <a href="/wiki/European_Medicines_Agency" title="European Medicines Agency">EMA</a> for recurrent <a href="/wiki/Clostridioides_difficile_infection" title="Clostridioides difficile infection">Clostridioides difficile infection</a>, and other monoclonal antibodies are in development (e.g. AR-301 for the adjunctive treatment of <i>S. aureus</i> <a href="/wiki/Ventilator-associated_pneumonia" title="Ventilator-associated pneumonia">ventilator-associated pneumonia</a>). Antibody treatments act by binding to and neutralizing bacterial exotoxins and other virulence factors.<sup id="cite_ref-pmid31295426_173-5" class="reference"><a href="#cite_note-pmid31295426-173"><span class="cite-bracket">&#91;</span>173<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-pmid30683453_174-3" class="reference"><a href="#cite_note-pmid30683453-174"><span class="cite-bracket">&#91;</span>174<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Phage_therapy">Phage therapy</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Antibiotic&amp;action=edit&amp;section=24" title="Edit section: Phage therapy"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Phage_therapy" title="Phage therapy">Phage therapy</a></div> <figure class="mw-default-size mw-halign-right" typeof="mw:File/Thumb"><a href="/wiki/File:Phage_injecting_its_genome_into_bacteria.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/2/29/Phage_injecting_its_genome_into_bacteria.svg/160px-Phage_injecting_its_genome_into_bacteria.svg.png" decoding="async" width="160" height="139" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/2/29/Phage_injecting_its_genome_into_bacteria.svg/240px-Phage_injecting_its_genome_into_bacteria.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/2/29/Phage_injecting_its_genome_into_bacteria.svg/320px-Phage_injecting_its_genome_into_bacteria.svg.png 2x" data-file-width="2316" data-file-height="2013" /></a><figcaption> Phage injecting its genome into a bacterium. Viral replication and bacterial cell lysis will ensue.<sup id="cite_ref-Sulakvelidze_200-0" class="reference"><a href="#cite_note-Sulakvelidze-200"><span class="cite-bracket">&#91;</span>200<span class="cite-bracket">&#93;</span></a></sup></figcaption></figure> <p><a href="/wiki/Phage_therapy" title="Phage therapy">Phage therapy</a> is under investigation as a method of treating antibiotic-resistant strains of bacteria. Phage therapy involves infecting bacterial pathogens with <a href="/wiki/Virus" title="Virus">viruses</a>. <a href="/wiki/Bacteriophage" title="Bacteriophage">Bacteriophages</a> and their host ranges are extremely specific for certain bacteria, thus, unlike antibiotics, they do not disturb the host organism's <a href="/wiki/Intestinal_microbiota" class="mw-redirect" title="Intestinal microbiota">intestinal microbiota</a>.<sup id="cite_ref-Gill,_Franco,_Hancock_201-0" class="reference"><a href="#cite_note-Gill,_Franco,_Hancock-201"><span class="cite-bracket">&#91;</span>201<span class="cite-bracket">&#93;</span></a></sup> Bacteriophages, also known as phages, infect and kill bacteria primarily during lytic cycles.<sup id="cite_ref-Gill,_Franco,_Hancock_201-1" class="reference"><a href="#cite_note-Gill,_Franco,_Hancock-201"><span class="cite-bracket">&#91;</span>201<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-Sulakvelidze_200-1" class="reference"><a href="#cite_note-Sulakvelidze-200"><span class="cite-bracket">&#91;</span>200<span class="cite-bracket">&#93;</span></a></sup> Phages insert their DNA into the bacterium, where it is transcribed and used to make new phages, after which the cell will lyse, releasing new phage that are able to infect and destroy further bacteria of the same strain.<sup id="cite_ref-Sulakvelidze_200-2" class="reference"><a href="#cite_note-Sulakvelidze-200"><span class="cite-bracket">&#91;</span>200<span class="cite-bracket">&#93;</span></a></sup> The high specificity of phage protects <a href="/wiki/Mutualism_(biology)" title="Mutualism (biology)">"good"</a> bacteria from destruction.<sup id="cite_ref-202" class="reference"><a href="#cite_note-202"><span class="cite-bracket">&#91;</span>202<span class="cite-bracket">&#93;</span></a></sup> </p><p>Some disadvantages to the use of bacteriophages also exist, however. Bacteriophages may harbour virulence factors or toxic genes in their genomes and, prior to use, it may be prudent to identify genes with similarity to known virulence factors or toxins by genomic sequencing. In addition, the oral and <a href="/wiki/Intravenous" class="mw-redirect" title="Intravenous">IV</a> administration of phages for the eradication of bacterial infections poses a much higher safety risk than topical application. Also, there is the additional concern of uncertain immune responses to these large antigenic cocktails.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">&#91;<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (January 2021)">citation needed</span></a></i>&#93;</sup> </p><p>There are considerable <a href="/wiki/Regulation_of_therapeutic_goods" title="Regulation of therapeutic goods">regulatory</a> hurdles that must be cleared for such therapies.<sup id="cite_ref-Gill,_Franco,_Hancock_201-2" class="reference"><a href="#cite_note-Gill,_Franco,_Hancock-201"><span class="cite-bracket">&#91;</span>201<span class="cite-bracket">&#93;</span></a></sup> Despite numerous challenges, the use of bacteriophages as a replacement for antimicrobial agents against MDR pathogens that no longer respond to conventional antibiotics, remains an attractive option.<sup id="cite_ref-Gill,_Franco,_Hancock_201-3" class="reference"><a href="#cite_note-Gill,_Franco,_Hancock-201"><span class="cite-bracket">&#91;</span>201<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-203" class="reference"><a href="#cite_note-203"><span class="cite-bracket">&#91;</span>203<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Fecal_microbiota_transplants">Fecal microbiota transplants</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Antibiotic&amp;action=edit&amp;section=25" title="Edit section: Fecal microbiota transplants"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Fecal_microbiota_transplant" title="Fecal microbiota transplant">Fecal microbiota transplant</a></div> <figure class="mw-default-size mw-halign-right" typeof="mw:File/Thumb"><a href="/wiki/File:E_coli_at_10000x,_original.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/b/bc/E_coli_at_10000x%2C_original.jpg/160px-E_coli_at_10000x%2C_original.jpg" decoding="async" width="160" height="116" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/b/bc/E_coli_at_10000x%2C_original.jpg/240px-E_coli_at_10000x%2C_original.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/b/bc/E_coli_at_10000x%2C_original.jpg/320px-E_coli_at_10000x%2C_original.jpg 2x" data-file-width="2598" data-file-height="1889" /></a><figcaption>Fecal microbiota transplants are an experimental treatment for <i>C. difficile</i> infection.<sup id="cite_ref-pmid31295426_173-6" class="reference"><a href="#cite_note-pmid31295426-173"><span class="cite-bracket">&#91;</span>173<span class="cite-bracket">&#93;</span></a></sup></figcaption></figure> <p>Fecal microbiota transplants involve transferring the full <a href="/wiki/Intestinal_microbiota" class="mw-redirect" title="Intestinal microbiota">intestinal microbiota</a> from a healthy human donor (in the form of <a href="/wiki/Feces" title="Feces">stool</a>) to patients with <a href="/wiki/Clostridioides_difficile_infection" title="Clostridioides difficile infection"><i>C. difficile</i> infection</a>. Although this procedure has not been officially approved by the <a href="/wiki/Food_and_Drug_Administration" title="Food and Drug Administration">US FDA</a>, its use is permitted under some conditions in patients with antibiotic-resistant <i>C. difficile</i> infection. Cure rates are around 90%, and work is underway to develop stool <a href="/wiki/Biobank" title="Biobank">banks</a>, standardized products, and methods of <a href="/wiki/Oral_administration" title="Oral administration">oral delivery</a>.<sup id="cite_ref-pmid31295426_173-7" class="reference"><a href="#cite_note-pmid31295426-173"><span class="cite-bracket">&#91;</span>173<span class="cite-bracket">&#93;</span></a></sup> Fecal microbiota transplantation has also been used more recently for inflammatory bowel diseases.<sup id="cite_ref-204" class="reference"><a href="#cite_note-204"><span class="cite-bracket">&#91;</span>204<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Antisense_RNA-based_treatments">Antisense RNA-based treatments</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Antibiotic&amp;action=edit&amp;section=26" title="Edit section: Antisense RNA-based treatments"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Further information: <a href="/wiki/Antisense_RNA" title="Antisense RNA">Antisense RNA</a></div> <p>Antisense RNA-based treatment (also known as gene silencing therapy) involves (a) identifying bacterial <a href="/wiki/Gene" title="Gene">genes</a> that encode essential <a href="/wiki/Protein" title="Protein">proteins</a> (e.g. the <i><a href="/wiki/Pseudomonas_aeruginosa" title="Pseudomonas aeruginosa">Pseudomonas aeruginosa</a></i> genes <i>acpP</i>, <i>lpxC</i>, and <i>rpsJ</i>), (b) synthesizing single-stranded <a href="/wiki/RNA" title="RNA">RNA</a> that is complementary to the <a href="/wiki/Messenger_RNA" title="Messenger RNA">mRNA</a> encoding these essential proteins, and (c) delivering the single-stranded RNA to the infection site using cell-penetrating peptides or <a href="/wiki/Liposome" title="Liposome">liposomes</a>. The antisense RNA then <a href="/wiki/Nucleic_acid_hybridization" title="Nucleic acid hybridization">hybridizes</a> with the bacterial mRNA and blocks its <a href="/wiki/Translation_(biology)" title="Translation (biology)">translation</a> into the essential protein. Antisense RNA-based treatment has been shown to be effective in <i>in vivo</i> models of <i>P. aeruginosa</i> <a href="/wiki/Lung_infection" class="mw-redirect" title="Lung infection">pneumonia</a>.<sup id="cite_ref-pmid31295426_173-8" class="reference"><a href="#cite_note-pmid31295426-173"><span class="cite-bracket">&#91;</span>173<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-pmid30683453_174-4" class="reference"><a href="#cite_note-pmid30683453-174"><span class="cite-bracket">&#91;</span>174<span class="cite-bracket">&#93;</span></a></sup> </p><p>In addition to silencing essential bacterial genes, antisense RNA can be used to silence bacterial genes responsible for antibiotic resistance.<sup id="cite_ref-pmid31295426_173-9" class="reference"><a href="#cite_note-pmid31295426-173"><span class="cite-bracket">&#91;</span>173<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-pmid30683453_174-5" class="reference"><a href="#cite_note-pmid30683453-174"><span class="cite-bracket">&#91;</span>174<span class="cite-bracket">&#93;</span></a></sup> For example, antisense RNA has been developed that silences the <i>S. aureus</i> <i><a href="/wiki/MecA" title="MecA">mecA</a></i> gene (the gene that encodes modified <a href="/wiki/Penicillin-binding_protein" class="mw-redirect" title="Penicillin-binding protein">penicillin-binding protein</a> 2a and renders <i>S. aureus</i> strains <a href="/wiki/Methicillin-resistant_Staphylococcus_aureus" title="Methicillin-resistant Staphylococcus aureus">methicillin-resistant</a>). Antisense RNA targeting <i>mecA</i> mRNA has been shown to restore the susceptibility of methicillin-resistant staphylococci to <a href="/wiki/Oxacillin" title="Oxacillin">oxacillin</a> in both <i>in vitro</i> and <i>in vivo</i> studies.<sup id="cite_ref-pmid30683453_174-6" class="reference"><a href="#cite_note-pmid30683453-174"><span class="cite-bracket">&#91;</span>174<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="CRISPR-Cas9-based_treatments">CRISPR-Cas9-based treatments</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Antibiotic&amp;action=edit&amp;section=27" title="Edit section: CRISPR-Cas9-based treatments"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>In the early 2000s, a system was discovered that enables bacteria to defend themselves against invading viruses. The system, known as CRISPR-Cas9, consists of (a) an enzyme that destroys DNA (the <a href="/wiki/Nuclease" title="Nuclease">nuclease</a> <a href="/wiki/Cas9" title="Cas9">Cas9</a>) and (b) the DNA sequences of previously encountered viral invaders (<a href="/wiki/CRISPR" title="CRISPR">CRISPR</a>). These viral DNA sequences enable the nuclease to target foreign (viral) rather than self (bacterial) DNA.<sup id="cite_ref-pmid29358495_205-0" class="reference"><a href="#cite_note-pmid29358495-205"><span class="cite-bracket">&#91;</span>205<span class="cite-bracket">&#93;</span></a></sup> </p><p>Although the function of CRISPR-Cas9 in nature is to protect bacteria, the DNA sequences in the CRISPR component of the system can be modified so that the Cas9 nuclease targets bacterial <a href="/wiki/Antimicrobial_resistance" title="Antimicrobial resistance">resistance</a> genes or bacterial <a href="/wiki/Virulence" title="Virulence">virulence</a> genes instead of viral genes. The modified CRISPR-Cas9 system can then be administered to bacterial pathogens using plasmids or bacteriophages.<sup id="cite_ref-pmid31295426_173-10" class="reference"><a href="#cite_note-pmid31295426-173"><span class="cite-bracket">&#91;</span>173<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-pmid30683453_174-7" class="reference"><a href="#cite_note-pmid30683453-174"><span class="cite-bracket">&#91;</span>174<span class="cite-bracket">&#93;</span></a></sup> This approach has successfully been used to <a href="/wiki/Gene_silencing" title="Gene silencing">silence</a> antibiotic resistance and reduce the virulence of <a href="/wiki/Shigatoxigenic_and_verotoxigenic_Escherichia_coli" title="Shigatoxigenic and verotoxigenic Escherichia coli">enterohemorrhagic <i>E. coli</i></a> in an <i>in vivo</i> model of infection.<sup id="cite_ref-pmid30683453_174-8" class="reference"><a href="#cite_note-pmid30683453-174"><span class="cite-bracket">&#91;</span>174<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Reducing_the_selection_pressure_for_antibiotic_resistance">Reducing the selection pressure for antibiotic resistance</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Antibiotic&amp;action=edit&amp;section=28" title="Edit section: Reducing the selection pressure for antibiotic resistance"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Antimicrobial_resistance" title="Antimicrobial resistance">Antimicrobial resistance</a></div> <figure class="mw-halign-right" typeof="mw:File/Thumb"><a href="/wiki/File:Share_of_population_using_safely_managed_sanitation_facilities,_OWID.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/e/e4/Share_of_population_using_safely_managed_sanitation_facilities%2C_OWID.svg/300px-Share_of_population_using_safely_managed_sanitation_facilities%2C_OWID.svg.png" decoding="async" width="300" height="212" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/e/e4/Share_of_population_using_safely_managed_sanitation_facilities%2C_OWID.svg/450px-Share_of_population_using_safely_managed_sanitation_facilities%2C_OWID.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/e/e4/Share_of_population_using_safely_managed_sanitation_facilities%2C_OWID.svg/600px-Share_of_population_using_safely_managed_sanitation_facilities%2C_OWID.svg.png 2x" data-file-width="850" data-file-height="600" /></a><figcaption> Share of population using safely managed sanitation facilities in 2015.<sup id="cite_ref-206" class="reference"><a href="#cite_note-206"><span class="cite-bracket">&#91;</span>206<span class="cite-bracket">&#93;</span></a></sup></figcaption></figure> <p>In addition to developing new antibacterial treatments, it is important to reduce the <a href="/wiki/Selection_pressure" class="mw-redirect" title="Selection pressure">selection pressure</a> for the emergence and spread of <a href="/wiki/Antimicrobial_resistance" title="Antimicrobial resistance">antimicrobial resistance</a> (AMR), such as antibiotic resistance. Strategies to accomplish this include well-established infection control measures such as infrastructure improvement (e.g. less crowded housing),<sup id="cite_ref-207" class="reference"><a href="#cite_note-207"><span class="cite-bracket">&#91;</span>207<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-pmid30545014_208-0" class="reference"><a href="#cite_note-pmid30545014-208"><span class="cite-bracket">&#91;</span>208<span class="cite-bracket">&#93;</span></a></sup> better sanitation (e.g. safe drinking water and food),<sup id="cite_ref-209" class="reference"><a href="#cite_note-209"><span class="cite-bracket">&#91;</span>209<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-pmid21453872_210-0" class="reference"><a href="#cite_note-pmid21453872-210"><span class="cite-bracket">&#91;</span>210<span class="cite-bracket">&#93;</span></a></sup> better use of vaccines and <a href="/wiki/Pipeline_vaccine" title="Pipeline vaccine">vaccine development</a>,<sup id="cite_ref-WHO10October2024_17-6" class="reference"><a href="#cite_note-WHO10October2024-17"><span class="cite-bracket">&#91;</span>17<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-pmid26795692_176-1" class="reference"><a href="#cite_note-pmid26795692-176"><span class="cite-bracket">&#91;</span>176<span class="cite-bracket">&#93;</span></a></sup> other approaches such as <a href="/wiki/Antibiotic_stewardship" class="mw-redirect" title="Antibiotic stewardship">antibiotic stewardship</a>,<sup id="cite_ref-pmid31836329_211-0" class="reference"><a href="#cite_note-pmid31836329-211"><span class="cite-bracket">&#91;</span>211<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-pmid31585470_212-0" class="reference"><a href="#cite_note-pmid31585470-212"><span class="cite-bracket">&#91;</span>212<span class="cite-bracket">&#93;</span></a></sup> and experimental approaches such as the use of <a href="/wiki/Prebiotic_(nutrition)" title="Prebiotic (nutrition)">prebiotics</a> and <a href="/wiki/Probiotics" class="mw-redirect" title="Probiotics">probiotics</a> to prevent infection.<sup id="cite_ref-pmid32800382_213-0" class="reference"><a href="#cite_note-pmid32800382-213"><span class="cite-bracket">&#91;</span>213<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-pmid31083597_214-0" class="reference"><a href="#cite_note-pmid31083597-214"><span class="cite-bracket">&#91;</span>214<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-215" class="reference"><a href="#cite_note-215"><span class="cite-bracket">&#91;</span>215<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-216" class="reference"><a href="#cite_note-216"><span class="cite-bracket">&#91;</span>216<span class="cite-bracket">&#93;</span></a></sup> Antibiotic cycling, where antibiotics are alternated by clinicians to treat microbial diseases, is proposed, but recent studies revealed such strategies are ineffective against antibiotic resistance.<sup id="cite_ref-217" class="reference"><a href="#cite_note-217"><span class="cite-bracket">&#91;</span>217<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-218" class="reference"><a href="#cite_note-218"><span class="cite-bracket">&#91;</span>218<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Vaccines">Vaccines</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Antibiotic&amp;action=edit&amp;section=29" title="Edit section: Vaccines"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><a href="/wiki/Vaccine" title="Vaccine">Vaccines</a> are an essential part of the response to reduce AMR as they prevent infections, reduce the use and overuse of antimicrobials, and slow the emergence and spread of drug-resistant pathogens.<sup id="cite_ref-WHO10October2024_17-7" class="reference"><a href="#cite_note-WHO10October2024-17"><span class="cite-bracket">&#91;</span>17<span class="cite-bracket">&#93;</span></a></sup> Vaccines rely on <a href="/wiki/Immune" class="mw-redirect" title="Immune">immune</a> modulation or augmentation. Vaccination either excites or reinforces the immune competence of a host to ward off infection, leading to the activation of <a href="/wiki/Macrophages" class="mw-redirect" title="Macrophages">macrophages</a>, the production of <a href="/wiki/Antibody" title="Antibody">antibodies</a>, <a href="/wiki/Inflammation" title="Inflammation">inflammation</a>, and other classic immune reactions. Antibacterial vaccines have been responsible for a drastic reduction in global bacterial diseases.<sup id="cite_ref-219" class="reference"><a href="#cite_note-219"><span class="cite-bracket">&#91;</span>219<span class="cite-bracket">&#93;</span></a></sup> Vaccines made from attenuated whole cells or lysates have been replaced largely by less reactogenic, cell-free vaccines consisting of purified components, including capsular polysaccharides and their conjugates, to protein carriers, as well as inactivated toxins (toxoids) and proteins.<sup id="cite_ref-220" class="reference"><a href="#cite_note-220"><span class="cite-bracket">&#91;</span>220<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="See_also">See also</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Antibiotic&amp;action=edit&amp;section=30" title="Edit section: See also"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1184024115"><div class="div-col" style="column-width: 30em;"> <ul><li><a href="/wiki/Anthelmintic" title="Anthelmintic">Anthelmintic</a></li> <li><a href="/wiki/Antifungal" title="Antifungal">Antifungal</a></li> <li><a href="/wiki/Antimalarial_medication" title="Antimalarial medication">Antimalarial medication</a></li> <li><a href="/wiki/Antiprotozoal" title="Antiprotozoal">Antiprotozoal</a></li> <li><a href="/wiki/Antiviral_drug" title="Antiviral drug">Antiviral drug</a></li> <li><a href="/wiki/Magic_bullet_(medicine)" title="Magic bullet (medicine)">Magic bullet (medicine)</a></li> <li><a href="/wiki/Prebiotic_(nutrition)" title="Prebiotic (nutrition)">Prebiotic (nutrition)</a></li> <li><a href="/wiki/Probiotic" title="Probiotic">Probiotic</a></li> <li><a href="/wiki/List_of_antibiotics" title="List of antibiotics">List of antibiotics</a></li></ul></div> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Antibiotic&amp;action=edit&amp;section=31" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap mw-references-columns"><ol class="references"> <li id="cite_note-NHSB-1"><span class="mw-cite-backlink">^ <a href="#cite_ref-NHSB_1-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-NHSB_1-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-NHSB_1-2"><sup><i><b>c</b></i></sup></a></span> <span class="reference-text"><style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}</style><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.nhs.uk/conditions/Antibiotics-penicillins/Pages/Introduction.aspx">"Antibiotics"</a>. NHS. 5 June 2014. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20150118023314/http://www.nhs.uk/conditions/antibiotics-penicillins/pages/introduction.aspx">Archived</a> from the original on 18 January 2015<span class="reference-accessdate">. Retrieved <span class="nowrap">17 January</span> 2015</span>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&amp;rft.genre=unknown&amp;rft.btitle=Antibiotics&amp;rft.pub=NHS&amp;rft.date=2014-06-05&amp;rft_id=https%3A%2F%2Fwww.nhs.uk%2Fconditions%2FAntibiotics-penicillins%2FPages%2FIntroduction.aspx&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AAntibiotic" class="Z3988"></span></span> </li> <li id="cite_note-2"><span class="mw-cite-backlink"><b><a href="#cite_ref-2">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://web.archive.org/web/20141221183712/http://ecdc.europa.eu/en/eaad/antibiotics/Pages/factsExperts.aspx">"Factsheet for experts"</a>. <a href="/wiki/European_Centre_for_Disease_Prevention_and_Control" title="European Centre for Disease Prevention and Control">European Centre for Disease Prevention and Control</a>. Archived from <a rel="nofollow" class="external text" href="http://ecdc.europa.eu/en/eaad/antibiotics/Pages/factsExperts.aspx">the original</a> on 21 December 2014<span class="reference-accessdate">. Retrieved <span class="nowrap">21 December</span> 2014</span>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&amp;rft.genre=unknown&amp;rft.btitle=Factsheet+for+experts&amp;rft.pub=European+Centre+for+Disease+Prevention+and+Control&amp;rft_id=http%3A%2F%2Fecdc.europa.eu%2Fen%2Feaad%2Fantibiotics%2FPages%2FfactsExperts.aspx&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AAntibiotic" class="Z3988"></span></span> </li> <li id="cite_note-3"><span class="mw-cite-backlink"><b><a href="#cite_ref-3">^</a></b></span> <span class="reference-text">For example, <a href="/wiki/Metronidazole" title="Metronidazole">metronidazole</a>: <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.drugs.com/monograph/metronidazole.html">"Metronidazole"</a>. <a href="/wiki/The_American_Society_of_Health-System_Pharmacists" class="mw-redirect" title="The American Society of Health-System Pharmacists">The American Society of Health-System Pharmacists</a>. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20150906002140/http://www.drugs.com/monograph/metronidazole.html">Archived</a> from the original on 6 September 2015<span class="reference-accessdate">. Retrieved <span class="nowrap">31 July</span> 2015</span>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&amp;rft.genre=unknown&amp;rft.btitle=Metronidazole&amp;rft.pub=The+American+Society+of+Health-System+Pharmacists&amp;rft_id=https%3A%2F%2Fwww.drugs.com%2Fmonograph%2Fmetronidazole.html&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AAntibiotic" class="Z3988"></span></span> </li> <li id="cite_note-Antibioticandantiprotozal-4"><span class="mw-cite-backlink">^ <a href="#cite_ref-Antibioticandantiprotozal_4-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Antibioticandantiprotozal_4-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation book cs1"><a rel="nofollow" class="external text" href="https://archive.org/details/antibioticssimpl0002gall/page/1"><i>Chemical Analysis of Antibiotic Residues in Food</i></a>. <a href="/wiki/John_Wiley_%26_Sons,_Inc." class="mw-redirect" title="John Wiley &amp; Sons, Inc.">John Wiley &amp; Sons, Inc.</a> 2012. pp.&#160;<a rel="nofollow" class="external text" href="https://archive.org/details/antibioticssimpl0002gall/page/1">1–60</a>. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a>&#160;<a href="/wiki/Special:BookSources/978-1-4496-1459-1" title="Special:BookSources/978-1-4496-1459-1"><bdi>978-1-4496-1459-1</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&amp;rft.genre=book&amp;rft.btitle=Chemical+Analysis+of+Antibiotic+Residues+in+Food.&amp;rft.pages=1-60&amp;rft.pub=John+Wiley+%26+Sons%2C+Inc.&amp;rft.date=2012&amp;rft.isbn=978-1-4496-1459-1&amp;rft_id=https%3A%2F%2Farchive.org%2Fdetails%2Fantibioticssimpl0002gall%2Fpage%2F1&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AAntibiotic" class="Z3988"></span></span> </li> <li id="cite_note-5"><span class="mw-cite-backlink"><b><a href="#cite_ref-5">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.health.qld.gov.au/news-events/news/antibiotics-viruses-cold-flu">"Why antibiotics can't be used to treat your cold or flu"</a>. <i>www.health.qld.gov.au</i>. 6 May 2017. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20200809150646/https://www.health.qld.gov.au/news-events/news/antibiotics-viruses-cold-flu">Archived</a> from the original on 9 August 2020<span class="reference-accessdate">. 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Retrieved <span class="nowrap">11 October</span> 2024</span>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=unknown&amp;rft.jtitle=World+Health+Organization&amp;rft.atitle=Better+use+of+vaccines+could+reduce+antibiotic+use+by+2.5+billion+doses+annually%2C+says+WHO&amp;rft.date=2024-10-10&amp;rft_id=https%3A%2F%2Fwww.who.int%2Fnews%2Fitem%2F10-10-2024-better-use-of-vaccines-could-reduce-antibiotic-use-by-2.5-billion-doses-annually--says-who&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AAntibiotic" class="Z3988"></span></span> </li> <li id="cite_note-WHO2014-18"><span class="mw-cite-backlink"><b><a href="#cite_ref-WHO2014_18-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation book cs1"><a rel="nofollow" class="external text" href="http://apps.who.int/iris/bitstream/10665/112642/1/9789241564748_eng.pdf?ua=1"><i>Antimicrobial resistance: global report on surveillance</i></a> <span class="cs1-format">(PDF)</span>. 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Oxford University Press, US. pp.&#160;<a rel="nofollow" class="external text" href="https://archive.org/details/antimicrobialdru0000scho/page/3">3</a>. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a>&#160;<a href="/wiki/Special:BookSources/978-0-19-512529-0" title="Special:BookSources/978-0-19-512529-0"><bdi>978-0-19-512529-0</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&amp;rft.genre=book&amp;rft.btitle=The+Antimicrobial+Drugs&amp;rft.pages=3&amp;rft.pub=Oxford+University+Press%2C+US&amp;rft.date=2000&amp;rft.isbn=978-0-19-512529-0&amp;rft.aulast=Scholar&amp;rft.aufirst=EM&amp;rft.au=Pratt%2C+WB&amp;rft_id=https%3A%2F%2Farchive.org%2Fdetails%2Fantimicrobialdru0000scho&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AAntibiotic" class="Z3988"></span></span> </li> <li id="cite_note-26"><span class="mw-cite-backlink"><b><a href="#cite_ref-26">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFDaviesDavies2010" class="citation journal cs1">Davies J, Davies D (September 2010). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2937522">"Origins and evolution of antibiotic resistance"</a>. <i>Microbiology and Molecular Biology Reviews</i>. <b>74</b> (3): 417–33. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1128%2FMMBR.00016-10">10.1128/MMBR.00016-10</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a>&#160;<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2937522">2937522</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a>&#160;<a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/20805405">20805405</a>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.jtitle=Microbiology+and+Molecular+Biology+Reviews&amp;rft.atitle=Origins+and+evolution+of+antibiotic+resistance&amp;rft.volume=74&amp;rft.issue=3&amp;rft.pages=417-33&amp;rft.date=2010-09&amp;rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC2937522%23id-name%3DPMC&amp;rft_id=info%3Apmid%2F20805405&amp;rft_id=info%3Adoi%2F10.1128%2FMMBR.00016-10&amp;rft.aulast=Davies&amp;rft.aufirst=J&amp;rft.au=Davies%2C+D&amp;rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC2937522&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AAntibiotic" class="Z3988"></span></span> </li> <li id="cite_note-27"><span class="mw-cite-backlink"><b><a href="#cite_ref-27">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFLiddellScott" class="citation book cs1">Liddell HG, Scott R (eds.). <a rel="nofollow" class="external text" href="https://www.perseus.tufts.edu/hopper/text?doc=Perseus%3Atext%3A1999.04.0057%3Aentry%3Dbiwtiko%2Fs">"βιωτικός"</a>. <i>A Greek-English Lexicon</i>. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20230425182154/https://www.perseus.tufts.edu/hopper/text?doc=Perseus:text:1999.04.0057:entry%3Dbiwtiko/s">Archived</a> from the original on 25 April 2023<span class="reference-accessdate">. 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Retrieved <span class="nowrap">20 February</span> 2021</span> &#8211; via <a href="/wiki/Perseus_Project" class="mw-redirect" title="Perseus Project">Perseus Project</a>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&amp;rft.genre=bookitem&amp;rft.atitle=%CE%B2%CE%AF%CF%89%CF%83%CE%B9%CF%82&amp;rft.btitle=A+Greek-English+Lexicon&amp;rft_id=https%3A%2F%2Fwww.perseus.tufts.edu%2Fhopper%2Ftext%3Fdoc%3DPerseus%253Atext%253A1999.04.0057%253Aentry%253Dbi%252Fwsis&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AAntibiotic" class="Z3988"></span></span> </li> <li id="cite_note-Antibiotics_FAQ-29"><span class="mw-cite-backlink">^ <a href="#cite_ref-Antibiotics_FAQ_29-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Antibiotics_FAQ_29-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://web.archive.org/web/20080216195750/http://www.mcgill.ca/studenthealth/information/generalhealth/antibiotics/">"Antibiotics FAQ"</a>. 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Retrieved <span class="nowrap">20 February</span> 2021</span> &#8211; via <a href="/wiki/Perseus_Project" class="mw-redirect" title="Perseus Project">Perseus Project</a>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&amp;rft.genre=bookitem&amp;rft.atitle=%E1%BC%80%CE%BD%CF%84%CE%AF&amp;rft.btitle=A+Greek-English+Lexicon&amp;rft_id=https%3A%2F%2Fwww.perseus.tufts.edu%2Fhopper%2Ftext%3Fdoc%3DPerseus%253Atext%253A1999.04.0057%253Aentry%253Da%2529nti%252F&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AAntibiotic" class="Z3988"></span></span> </li> <li id="cite_note-32"><span class="mw-cite-backlink"><b><a href="#cite_ref-32">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFLiddellScott" class="citation book cs1">Liddell HG, Scott R (eds.). <a rel="nofollow" class="external text" href="https://www.perseus.tufts.edu/hopper/text?doc=Perseus%3Atext%3A1999.04.0057%3Aentry%3Dbakthri%2Fa">"βακτηρία"</a>. <i>A Greek-English Lexicon</i>. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20210224153634/http://www.perseus.tufts.edu/hopper/text?doc=Perseus:text:1999.04.0057:entry=bakthri/a">Archived</a> from the original on 24 February 2021<span class="reference-accessdate">. Retrieved <span class="nowrap">20 February</span> 2021</span> &#8211; via <a href="/wiki/Perseus_Project" class="mw-redirect" title="Perseus Project">Perseus Project</a>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&amp;rft.genre=bookitem&amp;rft.atitle=%CE%B2%CE%B1%CE%BA%CF%84%CE%B7%CF%81%CE%AF%CE%B1&amp;rft.btitle=A+Greek-English+Lexicon&amp;rft_id=https%3A%2F%2Fwww.perseus.tufts.edu%2Fhopper%2Ftext%3Fdoc%3DPerseus%253Atext%253A1999.04.0057%253Aentry%253Dbakthri%252Fa&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AAntibiotic" class="Z3988"></span></span> </li> <li id="cite_note-33"><span class="mw-cite-backlink"><b><a href="#cite_ref-33">^</a></b></span> <span class="reference-text"><a rel="nofollow" class="external text" href="http://oxforddictionaries.com/definition/bacterium?q=bacterial#bacterium__2">bacterial</a> <a rel="nofollow" class="external text" href="https://web.archive.org/web/20210827221846/https://languages.oup.com/#bacterium__2">Archived</a> 27 August 2021 at the <a href="/wiki/Wayback_Machine" title="Wayback Machine">Wayback Machine</a>, on Oxford Dictionaries</span> </li> <li id="cite_note-Antibiotic-34"><span class="mw-cite-backlink">^ <a href="#cite_ref-Antibiotic_34-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Antibiotic_34-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-Antibiotic_34-2"><sup><i><b>c</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation book cs1"><a rel="nofollow" class="external text" href="https://books.google.com/books?id=vIRgA57q414C&amp;q=Antibiotics"><i>Antibiotics Simplified</i></a>. 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"Current strategies for antibacterial vaccine development". In Miller PF (ed.). <i>Emerging trends in antibacterial discovery: answering the call to arms</i>. Horizon Scientific Press. p.&#160;283.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&amp;rft.genre=bookitem&amp;rft.atitle=Current+strategies+for+antibacterial+vaccine+development&amp;rft.btitle=Emerging+trends+in+antibacterial+discovery%3A+answering+the+call+to+arms&amp;rft.pages=283&amp;rft.pub=Horizon+Scientific+Press&amp;rft.date=2011&amp;rft.aulast=Donald&amp;rft.aufirst=RG&amp;rft.au=Anderson%2C+AS&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AAntibiotic" class="Z3988"></span></span> </li> <li id="cite_note-220"><span class="mw-cite-backlink"><b><a href="#cite_ref-220">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFMiller2011" class="citation book cs1">Miller AA (2011). Miller PF (ed.). <i>Emerging trends in antibacterial discovery: answering the call to arms</i>. <a href="/wiki/Caister_Academic_Press" title="Caister Academic Press">Caister Academic Press</a>. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a>&#160;<a href="/wiki/Special:BookSources/978-1-904455-89-9" title="Special:BookSources/978-1-904455-89-9"><bdi>978-1-904455-89-9</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&amp;rft.genre=book&amp;rft.btitle=Emerging+trends+in+antibacterial+discovery%3A+answering+the+call+to+arms&amp;rft.pub=Caister+Academic+Press&amp;rft.date=2011&amp;rft.isbn=978-1-904455-89-9&amp;rft.aulast=Miller&amp;rft.aufirst=AA&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AAntibiotic" class="Z3988"></span><sup class="noprint Inline-Template" style="white-space:nowrap;">&#91;<i><a href="/wiki/Wikipedia:Citing_sources" title="Wikipedia:Citing sources"><span title="This citation requires a reference to the specific page or range of pages in which the material appears. (December 2013)">page&#160;needed</span></a></i>&#93;</sup></span> </li> </ol></div></div> <div class="mw-heading mw-heading2"><h2 id="Further_reading">Further reading</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Antibiotic&amp;action=edit&amp;section=32" title="Edit section: Further reading"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239549316">.mw-parser-output .refbegin{margin-bottom:0.5em}.mw-parser-output .refbegin-hanging-indents>ul{margin-left:0}.mw-parser-output .refbegin-hanging-indents>ul>li{margin-left:0;padding-left:3.2em;text-indent:-3.2em}.mw-parser-output .refbegin-hanging-indents ul,.mw-parser-output .refbegin-hanging-indents ul li{list-style:none}@media(max-width:720px){.mw-parser-output .refbegin-hanging-indents>ul>li{padding-left:1.6em;text-indent:-1.6em}}.mw-parser-output .refbegin-columns{margin-top:0.3em}.mw-parser-output .refbegin-columns ul{margin-top:0}.mw-parser-output .refbegin-columns li{page-break-inside:avoid;break-inside:avoid-column}@media screen{.mw-parser-output .refbegin{font-size:90%}}</style><div class="refbegin" style=""> <ul><li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFGould2016" class="citation journal cs1">Gould K (March 2016). <a rel="nofollow" class="external text" href="https://doi.org/10.1093%2Fjac%2Fdkv484">"Antibiotics: from prehistory to the present day"</a>. <i>The Journal of Antimicrobial Chemotherapy</i>. <b>71</b> (3): 572–5. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1093%2Fjac%2Fdkv484">10.1093/jac/dkv484</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a>&#160;<a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/26851273">26851273</a>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.jtitle=The+Journal+of+Antimicrobial+Chemotherapy&amp;rft.atitle=Antibiotics%3A+from+prehistory+to+the+present+day&amp;rft.volume=71&amp;rft.issue=3&amp;rft.pages=572-5&amp;rft.date=2016-03&amp;rft_id=info%3Adoi%2F10.1093%2Fjac%2Fdkv484&amp;rft_id=info%3Apmid%2F26851273&amp;rft.aulast=Gould&amp;rft.aufirst=K&amp;rft_id=https%3A%2F%2Fdoi.org%2F10.1093%252Fjac%252Fdkv484&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AAntibiotic" class="Z3988"></span></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFDaviesDavies2010" class="citation journal cs1">Davies J, Davies D (September 2010). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2937522">"Origins and evolution of antibiotic resistance"</a>. <i>Microbiology and Molecular Biology Reviews</i>. <b>74</b> (3): 417–33. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1128%2FMMBR.00016-10">10.1128/MMBR.00016-10</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a>&#160;<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2937522">2937522</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a>&#160;<a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/20805405">20805405</a>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.jtitle=Microbiology+and+Molecular+Biology+Reviews&amp;rft.atitle=Origins+and+evolution+of+antibiotic+resistance&amp;rft.volume=74&amp;rft.issue=3&amp;rft.pages=417-33&amp;rft.date=2010-09&amp;rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC2937522%23id-name%3DPMC&amp;rft_id=info%3Apmid%2F20805405&amp;rft_id=info%3Adoi%2F10.1128%2FMMBR.00016-10&amp;rft.aulast=Davies&amp;rft.aufirst=J&amp;rft.au=Davies%2C+D&amp;rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC2937522&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AAntibiotic" class="Z3988"></span></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://medlineplus.gov/antibiotics.html?PHPSESSID=1550cb08d53a1c0c39064bf62aee6247">"Antibiotics: MedlinePlus"</a>. nih.gov. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20160727195825/https://medlineplus.gov/antibiotics.html">Archived</a> from the original on 27 July 2016<span class="reference-accessdate">. Retrieved <span class="nowrap">19 July</span> 2016</span>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&amp;rft.genre=unknown&amp;rft.btitle=Antibiotics%3A+MedlinePlus&amp;rft.pub=nih.gov&amp;rft_id=https%3A%2F%2Fmedlineplus.gov%2Fantibiotics.html%3FPHPSESSID%3D1550cb08d53a1c0c39064bf62aee6247&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AAntibiotic" class="Z3988"></span></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://web.archive.org/web/20140430150557/http://www.who.int/mediacentre/news/releases/2014/amr-report/en/">"WHO's first global report on antibiotic resistance reveals serious, worldwide threat to public health"</a>. <i>WHO</i>. Archived from <a rel="nofollow" class="external text" href="https://www.who.int/mediacentre/news/releases/2014/amr-report/en/">the original</a> on 30 April 2014.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=unknown&amp;rft.jtitle=WHO&amp;rft.atitle=WHO%27s+first+global+report+on+antibiotic+resistance+reveals+serious%2C+worldwide+threat+to+public+health&amp;rft_id=https%3A%2F%2Fwww.who.int%2Fmediacentre%2Fnews%2Freleases%2F2014%2Famr-report%2Fen%2F&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AAntibiotic" class="Z3988"></span></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFPughGrantCookeDempsey2015" class="citation journal cs1">Pugh R, Grant C, Cooke RP, Dempsey G (August 2015). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7025798">"Short-course versus prolonged-course antibiotic therapy for hospital-acquired pneumonia in critically ill adults"</a>. <i>The Cochrane Database of Systematic Reviews</i>. <b>2015</b> (8): CD007577. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1002%2F14651858.CD007577.pub3">10.1002/14651858.CD007577.pub3</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a>&#160;<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7025798">7025798</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a>&#160;<a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/26301604">26301604</a>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.jtitle=The+Cochrane+Database+of+Systematic+Reviews&amp;rft.atitle=Short-course+versus+prolonged-course+antibiotic+therapy+for+hospital-acquired+pneumonia+in+critically+ill+adults&amp;rft.volume=2015&amp;rft.issue=8&amp;rft.pages=CD007577&amp;rft.date=2015-08&amp;rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC7025798%23id-name%3DPMC&amp;rft_id=info%3Apmid%2F26301604&amp;rft_id=info%3Adoi%2F10.1002%2F14651858.CD007577.pub3&amp;rft.aulast=Pugh&amp;rft.aufirst=R&amp;rft.au=Grant%2C+C&amp;rft.au=Cooke%2C+RP&amp;rft.au=Dempsey%2C+G&amp;rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC7025798&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AAntibiotic" class="Z3988"></span></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFGiedraitienėVitkauskienėNaginienėPavilonis2011" class="citation journal cs1">Giedraitienė A, Vitkauskienė A, Naginienė R, Pavilonis A (1 January 2011). <a rel="nofollow" class="external text" href="https://doi.org/10.3390%2Fmedicina47030019">"Antibiotic resistance mechanisms of clinically important bacteria"</a>. <i>Medicina</i>. <b>47</b> (3): 137–46. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.3390%2Fmedicina47030019">10.3390/medicina47030019</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a>&#160;<a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/21822035">21822035</a>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.jtitle=Medicina&amp;rft.atitle=Antibiotic+resistance+mechanisms+of+clinically+important+bacteria&amp;rft.volume=47&amp;rft.issue=3&amp;rft.pages=137-46&amp;rft.date=2011-01-01&amp;rft_id=info%3Adoi%2F10.3390%2Fmedicina47030019&amp;rft_id=info%3Apmid%2F21822035&amp;rft.aulast=Giedraitien%C4%97&amp;rft.aufirst=A&amp;rft.au=Vitkauskien%C4%97%2C+A&amp;rft.au=Naginien%C4%97%2C+R&amp;rft.au=Pavilonis%2C+A&amp;rft_id=https%3A%2F%2Fdoi.org%2F10.3390%252Fmedicina47030019&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AAntibiotic" class="Z3988"></span></li></ul> </div> <div class="mw-heading mw-heading2"><h2 id="External_links">External links</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Antibiotic&amp;action=edit&amp;section=33" title="Edit section: External links"><span>edit</span></a><span 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class="nv-edit"><a href="/wiki/Special:EditPage/Template:Use_of_antimicrobials" title="Special:EditPage/Template:Use of antimicrobials"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Use_of_antimicrobials" style="font-size:114%;margin:0 4em">Use of <a href="/wiki/Antimicrobial" title="Antimicrobial">antimicrobials</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%">Types</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Antibacterial" class="mw-redirect" title="Antibacterial">Antibacterial</a></li> <li><a href="/wiki/Antifungal" title="Antifungal">Antifungal</a></li> <li><a href="/wiki/Antiviral_drug" title="Antiviral drug">Antiviral</a></li> <li><a href="/wiki/Antiparasitic" title="Antiparasitic">Antiparasitic</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Concepts</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Antibiotic_sensitivity" class="mw-redirect" title="Antibiotic sensitivity">Antibiotic sensitivity</a></li> <li><a href="/wiki/Antimicrobial_resistance" title="Antimicrobial resistance">Antimicrobial resistance</a> <ul><li><a href="/wiki/Multiple_drug_resistance" title="Multiple drug resistance">multidrug</a></li></ul></li> <li><a href="/wiki/Antibiotic_prophylaxis" title="Antibiotic prophylaxis">Antibiotic prophylaxis</a></li> <li><a href="/wiki/Empiric_therapy" title="Empiric therapy">Empiric therapy</a></li> <li><a href="/wiki/Directed_therapy" title="Directed therapy">Directed therapy</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Social issues</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Antimicrobial_stewardship" title="Antimicrobial stewardship">Antimicrobial stewardship</a></li> <li><a href="/wiki/Antibiotic_misuse" title="Antibiotic misuse">Antibiotic misuse</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Pharmacology</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Antimicrobial_pharmacodynamics" title="Antimicrobial pharmacodynamics">Antimicrobial pharmacodynamics</a></li> <li><a href="/wiki/List_of_antibiotics" title="List of antibiotics">List of antibiotics</a></li> <li><a href="/wiki/Production_of_antibiotics" title="Production of antibiotics">Production of antibiotics</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Agriculture</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Antibiotic_use_in_livestock" title="Antibiotic use in livestock">Antibiotic use in livestock</a></li> <li><a href="/wiki/Antibiotics_in_poultry_farming_in_America" class="mw-redirect" title="Antibiotics in poultry farming in America">Antibiotics in poultry farming in America</a></li> <li><a href="/wiki/Subtherapeutic_antibiotic_use_in_swine" title="Subtherapeutic antibiotic use in swine">Subtherapeutic antibiotic use in swine</a></li> <li><a href="/wiki/Pesticide_resistance" title="Pesticide resistance">Pesticide resistance</a></li></ul> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Types_of_antibacterials" style="padding:3px"><table class="nowraplinks mw-collapsible mw-collapsed navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2" style="background:#e8e8ff;"><div id="Types_of_antibacterials" style="font-size:114%;margin:0 4em">Types of <a href="/wiki/Antibacterials" class="mw-redirect" title="Antibacterials">antibacterials</a></div></th></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0;font-size:114%"><div style="padding:0px"> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"></div><div role="navigation" class="navbox" aria-labelledby="Antibacterials_that_inhibit_protein_synthesis_(J01A,_J01B,_J01F,_J01G,_QJ01XQ)" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231"><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Protein_synthesis_inhibitor_antibiotics" title="Template:Protein synthesis inhibitor antibiotics"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Protein_synthesis_inhibitor_antibiotics" title="Template talk:Protein synthesis inhibitor antibiotics"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Protein_synthesis_inhibitor_antibiotics" title="Special:EditPage/Template:Protein synthesis inhibitor antibiotics"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Antibacterials_that_inhibit_protein_synthesis_(J01A,_J01B,_J01F,_J01G,_QJ01XQ)" style="font-size:114%;margin:0 4em"><a class="mw-selflink selflink">Antibacterials</a> that <a href="/wiki/Protein_synthesis_inhibitor" title="Protein synthesis inhibitor">inhibit protein synthesis</a> (<a href="/wiki/ATC_code_J01#J01A" title="ATC code J01">J01A</a>, <a href="/wiki/ATC_code_J01#J01B" title="ATC code J01">J01B</a>, <a href="/wiki/ATC_code_J01#J01F" title="ATC code J01">J01F</a>, <a href="/wiki/ATC_code_J01#J01G" title="ATC code J01">J01G</a>, <a href="/wiki/ATC_code_J01#QJ01XQ" title="ATC code J01">QJ01XQ</a>)</div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/30S" class="mw-redirect" title="30S">30S</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Aminoglycoside" title="Aminoglycoside">Aminoglycosides</a><br />(<a href="/wiki/Bacterial_translation#Initiation" title="Bacterial translation">initiation</a> inhibitors)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%">-mycin (<i><a href="/wiki/Streptomyces" title="Streptomyces">Streptomyces</a></i>)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Streptomycin" title="Streptomycin">Streptomycin</a><sup>#</sup></li> <li><a href="/wiki/Dihydrostreptomycin" title="Dihydrostreptomycin">Dihydrostreptomycin</a></li></ul> <ul><li><a href="/wiki/Neomycin" title="Neomycin">Neomycin</a><sup>#</sup> <ul><li><a href="/wiki/Framycetin" class="mw-redirect" title="Framycetin">Framycetin</a></li> <li><a href="/wiki/Paromomycin" title="Paromomycin">Paromomycin</a><sup>#</sup></li> <li><a href="/wiki/Ribostamycin" title="Ribostamycin">Ribostamycin</a></li></ul></li></ul> <ul><li><a href="/wiki/Kanamycin" class="mw-redirect" title="Kanamycin">Kanamycin</a> <ul><li><a href="/wiki/Amikacin" title="Amikacin">Amikacin</a><sup>#</sup></li> <li><a href="/wiki/Arbekacin" title="Arbekacin">Arbekacin</a></li> <li><a href="/wiki/Bekanamycin" title="Bekanamycin">Bekanamycin</a></li> <li><a href="/wiki/Dibekacin" title="Dibekacin">Dibekacin</a></li></ul></li></ul> <ul><li><a href="/wiki/Tobramycin" title="Tobramycin">Tobramycin</a> (<a href="/wiki/Loteprednol/tobramycin" title="Loteprednol/tobramycin">+loteprednol</a>)</li> <li><a href="/wiki/Spectinomycin" title="Spectinomycin">Spectinomycin</a><sup>#</sup></li> <li><a href="/wiki/Hygromycin_B" title="Hygromycin B">Hygromycin B</a></li> <li><a href="/wiki/Totomycin" title="Totomycin">Totomycin</a></li> <li><a href="/wiki/Apramycin" title="Apramycin">Apramycin</a></li> <li><a href="/wiki/Nourseothricin" title="Nourseothricin">Nourseothricin</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">-micin (<i><a href="/wiki/Micromonospora" title="Micromonospora">Micromonospora</a></i>)</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Gentamicin" title="Gentamicin">Gentamicin</a><sup>#</sup> <ul><li><a href="/wiki/Netilmicin" title="Netilmicin">Netilmicin</a></li> <li><a href="/wiki/Sisomicin" title="Sisomicin">Sisomicin</a></li> <li><a href="/wiki/Micronomicin" title="Micronomicin">Micronomicin</a></li> <li><a href="/wiki/Plazomicin" title="Plazomicin">Plazomicin</a><sup>#</sup></li> <li><a href="/wiki/Isepamicin" title="Isepamicin">Isepamicin</a></li></ul></li></ul> <ul><li><a href="/wiki/Verdamicin" title="Verdamicin">Verdamicin</a></li> <li><a href="/wiki/Astromicin" title="Astromicin">Astromicin</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">other</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Butirosin" title="Butirosin">Butirosin</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Tetracycline_antibiotics" title="Tetracycline antibiotics">Tetracycline antibiotics</a><br />(<a href="/wiki/Transfer_RNA" title="Transfer RNA">tRNA</a> binding)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%">Tetracyclines</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Doxycycline" title="Doxycycline">Doxycycline</a><sup>#</sup></li> <li><a href="/wiki/Chlortetracycline" title="Chlortetracycline">Chlortetracycline</a></li> <li><a href="/wiki/Clomocycline" title="Clomocycline">Clomocycline</a></li> <li><a href="/wiki/Demeclocycline" title="Demeclocycline">Demeclocycline</a></li> <li><a href="/wiki/Eravacycline" title="Eravacycline">Eravacycline</a></li> <li><a href="/wiki/Lymecycline" title="Lymecycline">Lymecycline</a></li> <li><a href="/wiki/Meclocycline" title="Meclocycline">Meclocycline</a><sup>‡</sup></li> <li><a href="/wiki/Metacycline" title="Metacycline">Metacycline</a></li> <li><a href="/wiki/Minocycline" title="Minocycline">Minocycline</a></li> <li><a href="/wiki/Omadacycline" title="Omadacycline">Omadacycline</a></li> <li><a href="/wiki/Oxytetracycline" title="Oxytetracycline">Oxytetracycline</a></li> <li><a href="/wiki/Penimepicycline" title="Penimepicycline">Penimepicycline</a></li> <li><a href="/wiki/Rolitetracycline" title="Rolitetracycline">Rolitetracycline</a></li> <li><a href="/wiki/Sarecycline" title="Sarecycline">Sarecycline</a></li> <li><a href="/wiki/Tetracycline" title="Tetracycline">Tetracycline</a><sup>#</sup></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Glycylcycline" title="Glycylcycline">Glycylcyclines</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Tigecycline" title="Tigecycline">Tigecycline</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/50S" class="mw-redirect" title="50S">50S</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/2-Oxazolidone" title="2-Oxazolidone">Oxazolidinone</a><br />(<a href="/wiki/Bacterial_translation#Initiation" title="Bacterial translation">initiation</a> inhibitors)</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Eperezolid" title="Eperezolid">Eperezolid</a></li> <li><a href="/wiki/Linezolid" title="Linezolid">Linezolid</a><sup>#</sup></li> <li><a href="/wiki/Posizolid" title="Posizolid">Posizolid</a></li> <li><a href="/wiki/Radezolid" title="Radezolid">Radezolid</a></li> <li><a href="/wiki/Ranbezolid" title="Ranbezolid">Ranbezolid</a></li> <li><a href="/wiki/Sutezolid" title="Sutezolid">Sutezolid</a></li> <li><a href="/wiki/Tedizolid" title="Tedizolid">Tedizolid</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Peptidyl_transferase" class="mw-redirect" title="Peptidyl transferase">Peptidyl transferase</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th id="Amphenicols" scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Amphenicol" title="Amphenicol">Amphenicols</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Chloramphenicol" title="Chloramphenicol">Chloramphenicol</a><sup>#</sup></li> <li><a href="/wiki/Azidamfenicol" title="Azidamfenicol">Azidamfenicol</a></li> <li><a href="/wiki/Thiamphenicol" title="Thiamphenicol">Thiamphenicol</a></li> <li><a href="/wiki/Florfenicol" title="Florfenicol">Florfenicol</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">MLS (<a href="/wiki/Bacterial_translation#Elongation" title="Bacterial translation">transpeptidation/translocation</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Macrolide" title="Macrolide">Macrolides</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Azithromycin" title="Azithromycin">Azithromycin</a><sup>#</sup></li> <li><a href="/wiki/Boromycin" title="Boromycin">Boromycin</a></li> <li><a href="/wiki/Carbomycin" title="Carbomycin">Carbomycin</a></li> <li><a href="/wiki/Carrimycin" title="Carrimycin">Carrimycin</a></li> <li><a href="/wiki/Clarithromycin" title="Clarithromycin">Clarithromycin</a><sup>#</sup></li> <li><a href="/wiki/Dirithromycin" title="Dirithromycin">Dirithromycin</a></li> <li><a href="/wiki/Erythromycin" title="Erythromycin">Erythromycin</a><sup>#</sup></li> <li><a href="/wiki/Flurithromycin" title="Flurithromycin">Flurithromycin</a></li> <li><a href="/wiki/Gamithromycin" title="Gamithromycin">Gamithromycin</a></li> <li><a href="/wiki/Josamycin" title="Josamycin">Josamycin</a></li> <li><a href="/wiki/Kitasamycin" title="Kitasamycin">Kitasamycin</a></li> <li><a href="/wiki/Midecamycin" title="Midecamycin">Midecamycin</a></li> <li><a href="/wiki/Miocamycin" title="Miocamycin">Miocamycin</a></li> <li><a href="/wiki/Oleandomycin" title="Oleandomycin">Oleandomycin</a></li> <li><a href="/wiki/Rokitamycin" title="Rokitamycin">Rokitamycin</a></li> <li><a href="/wiki/Roxithromycin" title="Roxithromycin">Roxithromycin</a></li> <li><a href="/wiki/Solithromycin" title="Solithromycin">Solithromycin</a></li> <li><a href="/wiki/Spiramycin" title="Spiramycin">Spiramycin</a></li> <li><a href="/wiki/Telithromycin" title="Telithromycin">Telithromycin</a></li> <li><a href="/wiki/Tildipirosin" title="Tildipirosin">Tildipirosin</a></li> <li><a href="/wiki/Tilmicosin" title="Tilmicosin">Tilmicosin</a></li> <li><a href="/wiki/Troleandomycin" title="Troleandomycin">Troleandomycin</a></li> <li><a href="/wiki/Tulathromycin" title="Tulathromycin">Tulathromycin</a></li> <li><a href="/wiki/Tylosin" title="Tylosin">Tylosin</a></li> <li><a href="/wiki/Tylvalosin" title="Tylvalosin">Tylvalosin</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Ketolide" title="Ketolide">Ketolides</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Telithromycin" title="Telithromycin">Telithromycin</a><sup>‡</sup></li> <li><a href="/wiki/Cethromycin" title="Cethromycin">Cethromycin</a></li> <li><a href="/wiki/Solithromycin" title="Solithromycin">Solithromycin</a><sup>†</sup></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Lincosamides" title="Lincosamides">Lincosamides</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Clindamycin" title="Clindamycin">Clindamycin</a><sup>#</sup></li> <li><a href="/wiki/Lincomycin" title="Lincomycin">Lincomycin</a></li> <li><a href="/wiki/Pirlimycin" title="Pirlimycin">Pirlimycin</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Streptogramin" title="Streptogramin">Streptogramins</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Pristinamycin" title="Pristinamycin">Pristinamycin</a> (<a href="/wiki/Pristinamycin_IA" title="Pristinamycin IA">IA</a>, <a href="/wiki/Pristinamycin_IIA" title="Pristinamycin IIA">IIA</a>, <a href="/wiki/Pristinamycin_IIB" title="Pristinamycin IIB">IIB</a>)</li> <li><a href="/wiki/NXL103" class="mw-redirect" title="NXL103">NXL103</a> (<a href="/wiki/Flopristin" title="Flopristin">Flopristin</a>, <a href="/wiki/Linopristin" title="Linopristin">Linopristin</a>)</li> <li><a href="/wiki/Quinupristin/dalfopristin" title="Quinupristin/dalfopristin">Quinupristin/dalfopristin</a> (<a href="/wiki/Dalfopristin" title="Dalfopristin">Dalfopristin</a>, <a href="/wiki/Quinupristin" title="Quinupristin">Quinupristin</a>)</li> <li><a href="/wiki/Streptogramin_A" title="Streptogramin A">Streptogramin A</a></li> <li><a href="/wiki/Streptogramin_B" title="Streptogramin B">Streptogramin B</a></li> <li><a href="/wiki/Virginiamycin" title="Virginiamycin">Virginiamycin</a> (<a href="/wiki/Virginiamycin_S1" title="Virginiamycin S1">S1</a>)</li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table><div></div></td></tr><tr><td class="navbox-abovebelow" colspan="2" style="background: transparent; padding: 0px;"><div><div class="hlist"> <ul><li><sup>#</sup><a href="/wiki/WHO_Model_List_of_Essential_Medicines" title="WHO Model List of Essential Medicines">WHO-EM</a></li> <li><sup>‡</sup><a href="/wiki/List_of_withdrawn_drugs" title="List of withdrawn drugs">Withdrawn</a> from market</li> <li><a href="/wiki/Clinical_trial" title="Clinical trial">Clinical trials</a>: <ul><li><sup>†</sup><a href="/wiki/Phases_of_clinical_research#Phase_III" title="Phases of clinical research">Phase III</a></li> <li><sup>§</sup>Never to phase III</li></ul></li></ul> </div></div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"><style data-mw-deduplicate="TemplateStyles:r886047488">.mw-parser-output .nobold{font-weight:normal}</style><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"></div><div role="navigation" class="navbox" aria-labelledby="Antibacterials_active_on_the_cell_wall_and_envelope_(J01C-J01D)" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231"><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Cell_wall_disruptive_antibiotics" title="Template:Cell wall disruptive antibiotics"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Cell_wall_disruptive_antibiotics" title="Template talk:Cell wall disruptive antibiotics"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Cell_wall_disruptive_antibiotics" title="Special:EditPage/Template:Cell wall disruptive antibiotics"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Antibacterials_active_on_the_cell_wall_and_envelope_(J01C-J01D)" style="font-size:114%;margin:0 4em"><a href="/wiki/Antibiotics" class="mw-redirect" title="Antibiotics">Antibacterials</a> active on the <a href="/wiki/Cell_wall" title="Cell wall">cell wall</a> and <a href="/wiki/Cell_envelope_antibiotic" title="Cell envelope antibiotic">envelope</a> (<a href="/wiki/ATC_code_J01#J01C" title="ATC code J01">J01C</a>-<a href="/wiki/ATC_code_J01#J01D" title="ATC code J01">J01D</a>)</div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Beta-lactam_antibiotics" class="mw-redirect" title="Beta-lactam antibiotics">β-lactams</a><br /><small><span class="nobold">(inhibit synthesis<br />of peptidoglycan<br />layer of bacterial<br />cell wall by binding<br />to and inhibiting<br /><a href="/wiki/Penicillin-binding_proteins" title="Penicillin-binding proteins">PBPs</a>, a group of<br /><a href="/wiki/DD-Transpeptidase" title="DD-Transpeptidase"><small>D</small>-alanyl-<small>D</small>-alanine<br />transpeptidases</a>)</span></small></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Penicillin" title="Penicillin">Penicillins</a> (<a href="/wiki/Penam" title="Penam">Penams</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/List_of_%CE%B2-lactam_antibiotics#Narrow-spectrum" title="List of β-lactam antibiotics">Narrow<br />spectrum</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/List_of_%CE%B2-lactam_antibiotics#Narrow-spectrum" title="List of β-lactam antibiotics">β-lactamase sensitive</a><br />(1st generation)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Benzylpenicillin" title="Benzylpenicillin">Benzylpenicillin (G)</a><sup>#</sup></li> <li><a href="/wiki/Benzathine_benzylpenicillin" title="Benzathine benzylpenicillin">Benzathine benzylpenicillin</a><sup>#</sup></li> <li><a href="/wiki/Procaine_benzylpenicillin" title="Procaine benzylpenicillin">Procaine benzylpenicillin</a><sup>#</sup></li> <li><a href="/wiki/Phenoxymethylpenicillin" title="Phenoxymethylpenicillin">Phenoxymethylpenicillin (V)</a><sup>#</sup></li> <li><a href="/wiki/Propicillin" title="Propicillin">Propicillin</a><sup>‡</sup></li> <li><a href="/wiki/Pheneticillin" title="Pheneticillin">Pheneticillin</a><sup>‡</sup></li> <li><a href="/wiki/Azidocillin" title="Azidocillin">Azidocillin</a><sup>‡</sup></li> <li><a href="/wiki/Clometocillin" title="Clometocillin">Clometocillin</a><sup>‡</sup></li> <li><a href="/wiki/Penamecillin" title="Penamecillin">Penamecillin</a><sup>‡</sup></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/List_of_%CE%B2-lactam_antibiotics#β-lactamase-resistant" title="List of β-lactam antibiotics">β-lactamase resistant</a><br />(2nd generation)</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Cloxacillin" title="Cloxacillin">Cloxacillin</a><sup>#</sup> (<a href="/wiki/Dicloxacillin" title="Dicloxacillin">Dicloxacillin</a></li> <li><a href="/wiki/Flucloxacillin" title="Flucloxacillin">Flucloxacillin</a>)</li> <li><a href="/wiki/Oxacillin" title="Oxacillin">Oxacillin</a></li> <li><a href="/wiki/Nafcillin" title="Nafcillin">Nafcillin</a></li> <li><a href="/wiki/Methicillin" title="Methicillin">Methicillin</a><sup>‡</sup></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Extended-spectrum_penicillin" title="Extended-spectrum penicillin">Extended<br />spectrum</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Aminopenicillin" title="Aminopenicillin">Aminopenicillins</a> (3rd generation)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Amoxicillin" title="Amoxicillin">Amoxicillin</a><sup>#</sup></li> <li><a href="/wiki/Ampicillin" title="Ampicillin">Ampicillin</a><sup>#</sup> (<a href="/wiki/Pivampicillin" title="Pivampicillin">Pivampicillin</a></li> <li><a href="/wiki/Hetacillin" title="Hetacillin">Hetacillin</a><sup>‡</sup></li> <li><a href="/wiki/Bacampicillin" title="Bacampicillin">Bacampicillin</a><sup>‡</sup></li> <li><a href="/wiki/Lenampicillin" title="Lenampicillin">Lenampicillin</a></li> <li><a href="/wiki/Metampicillin" title="Metampicillin">Metampicillin</a><sup>‡</sup></li> <li><a href="/wiki/Talampicillin" title="Talampicillin">Talampicillin</a><sup>‡</sup>)</li> <li><a href="/wiki/Epicillin" title="Epicillin">Epicillin</a><sup>‡</sup></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Carboxypenicillin" title="Carboxypenicillin">Carboxypenicillins</a> (4th generation)</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Ticarcillin" title="Ticarcillin">Ticarcillin</a></li> <li><a href="/wiki/Carbenicillin" title="Carbenicillin">Carbenicillin</a><sup>‡</sup> / <a href="/wiki/Carindacillin" title="Carindacillin">Carindacillin</a><sup>‡</sup></li> <li><a href="/wiki/Temocillin" title="Temocillin">Temocillin</a><sup>‡</sup></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Ureidopenicillin" title="Ureidopenicillin">Ureidopenicillins</a> (4th generation)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Piperacillin" title="Piperacillin">Piperacillin</a></li> <li><a href="/wiki/Azlocillin" title="Azlocillin">Azlocillin</a><sup>‡</sup></li> <li><a href="/wiki/Mezlocillin" title="Mezlocillin">Mezlocillin</a><sup>‡</sup></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Mecillinam" title="Mecillinam">Mecillinam</a> (<a href="/wiki/Pivmecillinam" title="Pivmecillinam">Pivmecillinam</a>)</li> <li><a href="/wiki/Sulbenicillin" title="Sulbenicillin">Sulbenicillin</a><sup>‡</sup></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Carbapenem" title="Carbapenem">Carbapenems</a> / <a href="/wiki/Penem" title="Penem">Penems</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li>Carbapenems (<a href="/wiki/Ertapenem" title="Ertapenem">Ertapenem</a></li> <li><a href="/wiki/Antipseudomonal" class="mw-redirect" title="Antipseudomonal">Antipseudomonal</a> (<a href="/wiki/Doripenem" title="Doripenem">Doripenem</a></li> <li><a href="/wiki/Imipenem" title="Imipenem">Imipenem</a></li> <li><a href="/wiki/Meropenem" title="Meropenem">Meropenem</a>)</li> <li><a href="/wiki/Biapenem" title="Biapenem">Biapenem</a><sup>‡</sup></li> <li><a href="/wiki/Panipenem" title="Panipenem">Panipenem</a>)</li> <li>Penems (<a href="/wiki/Faropenem" title="Faropenem">Faropenem</a></li> <li><a href="/wiki/Ritipenem" title="Ritipenem">Ritipenem</a><sup>§</sup></li> <li><a href="/wiki/Sulopenem" title="Sulopenem">Sulopenem</a>)</li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Cephem" title="Cephem">Cephems</a><br /><a href="/wiki/Cephalosporin" title="Cephalosporin">Cephalosporins</a><br /><a href="/wiki/Cephamycin" title="Cephamycin">Cephamycins</a><br /><a href="/wiki/Carbacephem" title="Carbacephem">Carbacephems</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Cephalosporin#First_generation" title="Cephalosporin">1st generation</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Cefazolin" title="Cefazolin">Cefazolin</a><sup>#</sup></li> <li><a href="/wiki/Cefalexin" title="Cefalexin">Cefalexin</a> <sup>#</sup></li> <li><a href="/wiki/Cefadroxil" title="Cefadroxil">Cefadroxil</a></li> <li><a href="/wiki/Cefapirin" title="Cefapirin">Cefapirin</a></li> <li><a href="/wiki/Cefazedone" title="Cefazedone">Cefazedone</a><sup>‡</sup></li> <li><a href="/wiki/Cefazaflur" title="Cefazaflur">Cefazaflur</a><sup>‡</sup></li> <li><a href="/wiki/Cefradine" title="Cefradine">Cefradine</a><sup>‡</sup></li> <li><a href="/wiki/Cefroxadine" title="Cefroxadine">Cefroxadine</a><sup>‡</sup></li> <li><a href="/wiki/Ceftezole" title="Ceftezole">Ceftezole</a><sup>‡</sup></li> <li><a href="/wiki/Cefaloglycin" title="Cefaloglycin">Cefaloglycin</a><sup>‡</sup></li> <li><a href="/wiki/Cefacetrile" title="Cefacetrile">Cefacetrile</a><sup>‡</sup></li> <li><a href="/wiki/Cefalonium" title="Cefalonium">Cefalonium</a><sup>‡</sup></li> <li><a href="/wiki/Cefaloridine" class="mw-redirect" title="Cefaloridine">Cefaloridine</a><sup>‡</sup></li> <li><a href="/wiki/Cefalotin" title="Cefalotin">Cefalotin</a></li> <li><a href="/wiki/Cefatrizine" title="Cefatrizine">Cefatrizine</a><sup>‡</sup></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Cephalosporin#Second_generation" title="Cephalosporin">2nd generation</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Cefaclor" title="Cefaclor">Cefaclor</a></li> <li><a href="/wiki/Cefprozil" title="Cefprozil">Cefprozil</a></li> <li><a href="/wiki/Cefuroxime" title="Cefuroxime">Cefuroxime</a></li> <li><a href="/wiki/Cefuroxime_axetil" title="Cefuroxime axetil">Cefuroxime axetil</a></li> <li><a href="/wiki/Cefamandole" title="Cefamandole">Cefamandole</a><sup>‡</sup></li> <li><a href="/wiki/Cefonicid" title="Cefonicid">Cefonicid</a><sup>‡</sup></li> <li><a href="/wiki/Ceforanide" title="Ceforanide">Ceforanide</a><sup>‡</sup></li> <li><a href="/wiki/Cefuzonam" title="Cefuzonam">Cefuzonam</a><sup>‡</sup></li> <li><a href="/wiki/Cephamycin" title="Cephamycin">Cephamycin</a> (<a href="/wiki/Cefoxitin" title="Cefoxitin">Cefoxitin</a></li> <li><a href="/wiki/Cefotetan" title="Cefotetan">Cefotetan</a></li> <li><a href="/wiki/Cefminox" title="Cefminox">Cefminox</a><sup>‡</sup></li> <li><a href="/wiki/Cefbuperazone" title="Cefbuperazone">Cefbuperazone</a><sup>‡</sup></li> <li><a href="/wiki/Cefmetazole" title="Cefmetazole">Cefmetazole</a><sup>‡</sup>)</li> <li><a href="/wiki/Carbacephem" title="Carbacephem">Carbacephem</a> (<a href="/wiki/Loracarbef" title="Loracarbef">Loracarbef</a><sup>‡</sup>)</li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Cephalosporin#Third_generation" title="Cephalosporin">3rd generation</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Cefixime" title="Cefixime">Cefixime</a><sup>#</sup></li> <li><a href="/wiki/Ceftriaxone" title="Ceftriaxone">Ceftriaxone</a><sup>#</sup></li> <li><a href="/wiki/Cefotaxime" title="Cefotaxime">Cefotaxime</a><sup>#</sup></li> <li>Antipseudomonal (<a href="/wiki/Ceftazidime" title="Ceftazidime">Ceftazidime</a><sup>#</sup></li> <li><a href="/wiki/Cefoperazone" title="Cefoperazone">Cefoperazone</a>)</li> <li><a href="/wiki/Cefdinir" title="Cefdinir">Cefdinir</a></li> <li><a href="/wiki/Cefcapene" title="Cefcapene">Cefcapene</a></li> <li><a href="/wiki/Cefdaloxime" title="Cefdaloxime">Cefdaloxime</a></li> <li><a href="/wiki/Ceftizoxime" title="Ceftizoxime">Ceftizoxime</a></li> <li><a href="/wiki/Cefmenoxime" title="Cefmenoxime">Cefmenoxime</a></li> <li><a href="/wiki/Cefpiramide" title="Cefpiramide">Cefpiramide</a></li> <li><a href="/wiki/Cefpodoxime" title="Cefpodoxime">Cefpodoxime</a></li> <li><a href="/wiki/Ceftibuten" title="Ceftibuten">Ceftibuten</a></li> <li><a href="/wiki/Cefditoren" title="Cefditoren">Cefditoren</a></li> <li><a href="/wiki/Cefotiam" title="Cefotiam">Cefotiam</a><sup>‡</sup></li> <li><a href="/wiki/Cefetamet" title="Cefetamet">Cefetamet</a><sup>‡</sup></li> <li><a href="/wiki/Cefodizime" title="Cefodizime">Cefodizime</a><sup>‡</sup></li> <li><a href="/wiki/Cefpimizole" title="Cefpimizole">Cefpimizole</a><sup>‡</sup></li> <li><a href="/wiki/Cefsulodin" title="Cefsulodin">Cefsulodin</a><sup>‡</sup></li> <li><a href="/wiki/Cefteram" title="Cefteram">Cefteram</a><sup>‡</sup></li> <li><a href="/wiki/Ceftiolene" title="Ceftiolene">Ceftiolene</a><sup>‡</sup></li> <li><a href="/wiki/Oxacephem" title="Oxacephem">Oxacephem</a> (<a href="/wiki/Flomoxef" title="Flomoxef">Flomoxef</a></li> <li><a href="/wiki/Latamoxef" title="Latamoxef">Latamoxef</a><sup>‡</sup>)</li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Cephalosporin#Fourth_generation" title="Cephalosporin">4th generation</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Cefepime" title="Cefepime">Cefepime</a></li> <li><a href="/wiki/Cefozopran" title="Cefozopran">Cefozopran</a><sup>‡</sup></li> <li><a href="/wiki/Cefpirome" title="Cefpirome">Cefpirome</a></li> <li><a href="/wiki/Cefquinome" title="Cefquinome">Cefquinome</a><sup>‡</sup></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Cephalosporin#Fifth_generation" title="Cephalosporin">5th generation</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Ceftaroline_fosamil" title="Ceftaroline fosamil">Ceftaroline fosamil</a></li> <li><a href="/wiki/Ceftolozane" class="mw-redirect" title="Ceftolozane">Ceftolozane</a></li> <li><a href="/wiki/Ceftobiprole" title="Ceftobiprole">Ceftobiprole</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Siderophore" title="Siderophore">Siderophore</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Cefiderocol" title="Cefiderocol">Cefiderocol</a><sup>#</sup></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Veterinary_medicine" title="Veterinary medicine">Veterinary</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Ceftiofur" title="Ceftiofur">Ceftiofur</a></li> <li><a href="/wiki/Cefquinome" title="Cefquinome">Cefquinome</a></li> <li><a href="/wiki/Cefovecin" title="Cefovecin">Cefovecin</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Monobactam" title="Monobactam">Monobactams</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Aztreonam" title="Aztreonam">Aztreonam</a></li> <li><a href="/wiki/Tigemonam" title="Tigemonam">Tigemonam</a><sup>‡</sup></li> <li><a href="/wiki/Carumonam" title="Carumonam">Carumonam</a><sup>‡</sup></li> <li><a href="/wiki/Nocardicin_A" title="Nocardicin A">Nocardicin A</a><sup>‡</sup></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/%CE%92-Lactamase_inhibitor" title="Β-Lactamase inhibitor">β-lactamase inhibitors</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Penam" title="Penam">Penam</a> (<a href="/wiki/Sulbactam" title="Sulbactam">Sulbactam</a></li> <li><a href="/wiki/Tazobactam" title="Tazobactam">Tazobactam</a>)</li> <li><a href="/wiki/Clavam" title="Clavam">Clavam</a> (<a href="/wiki/Clavulanic_acid" title="Clavulanic acid">Clavulanic acid</a>)</li> <li>non-β-lactam (<a href="/wiki/Avibactam" title="Avibactam">Avibactam</a></li> <li><a href="/wiki/Durlobactam" title="Durlobactam">Durlobactam</a></li> <li><a href="/wiki/Relebactam" title="Relebactam">Relebactam</a></li> <li><a href="/wiki/Vaborbactam" title="Vaborbactam">Vaborbactam</a>)</li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Combinations</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Amoxicillin/clavulanic_acid" title="Amoxicillin/clavulanic acid">Amoxicillin/clavulanic acid</a><sup>#</sup></li> <li><a href="/wiki/Ampicillin/flucloxacillin" title="Ampicillin/flucloxacillin">Ampicillin/flucloxacillin</a></li> <li><a href="/wiki/Ampicillin/sulbactam" title="Ampicillin/sulbactam">Ampicillin/sulbactam</a> (<a href="/wiki/Sultamicillin" title="Sultamicillin">Sultamicillin</a>)</li> <li><a href="/wiki/Aztreonam/avibactam" title="Aztreonam/avibactam">Aztreonam/avibactam</a></li> <li><a href="/wiki/Benzathine_benzylpenicillin/procaine_benzylpenicillin" title="Benzathine benzylpenicillin/procaine benzylpenicillin">Benzathine benzylpenicillin/procaine benzylpenicillin</a></li> <li><a href="/wiki/Cefepime/enmetazobactam" title="Cefepime/enmetazobactam">Cefepime/enmetazobactam</a></li> <li><a href="/wiki/Cefoperazone/sulbactam" title="Cefoperazone/sulbactam">Cefoperazone/sulbactam</a></li> <li><a href="/wiki/Ceftazidime/avibactam" title="Ceftazidime/avibactam">Ceftazidime/avibactam</a></li> <li><a href="/wiki/Ceftolozane/tazobactam" title="Ceftolozane/tazobactam">Ceftolozane/tazobactam</a></li> <li><a href="/wiki/Imipenem/cilastatin" title="Imipenem/cilastatin">Imipenem/cilastatin</a><sup>#</sup></li> <li><a href="/wiki/Imipenem/cilastatin/relebactam" title="Imipenem/cilastatin/relebactam">Imipenem/cilastatin/relebactam</a></li> <li><a href="/wiki/Meropenem/vaborbactam" title="Meropenem/vaborbactam">Meropenem/vaborbactam</a></li> <li><a href="/wiki/Panipenem/betamipron" title="Panipenem/betamipron">Panipenem/betamipron</a></li> <li><a href="/wiki/Piperacillin/tazobactam" title="Piperacillin/tazobactam">Piperacillin/tazobactam</a></li> <li><a href="/wiki/Sulbactam/durlobactam" title="Sulbactam/durlobactam">Sulbactam/durlobactam</a></li> <li><a href="/wiki/Sulopenem/probenecid" title="Sulopenem/probenecid">Sulopenem/probenecid</a></li> <li><a href="/wiki/Ticarcillin/clavulanic_acid" title="Ticarcillin/clavulanic acid">Ticarcillin/clavulanic acid</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Polypeptide_antibiotic" title="Polypeptide antibiotic">Polypeptides</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Lipopeptide" title="Lipopeptide">Lipopeptides</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li>Insert into bacterial cell wall causing perforation and depolarization: <a href="/wiki/Daptomycin" title="Daptomycin">Daptomycin</a></li> <li><a href="/wiki/Surfactin" title="Surfactin">Surfactin</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li>Inhibits PG elongation and crosslinking: <a href="/wiki/Ramoplanin" title="Ramoplanin">Ramoplanin</a><sup>§</sup></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Intracellular</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li>Inhibit <a href="/wiki/Peptidoglycan" title="Peptidoglycan">PG</a> subunit synthesis and transport: <a href="/wiki/N-Acetylmuramic_acid" title="N-Acetylmuramic acid">NAM</a> synthesis inhibition (<a href="/wiki/Fosfomycin" title="Fosfomycin">Fosfomycin</a>)</li> <li><a href="/wiki/D-alanine%E2%80%94D-alanine_ligase" title="D-alanine—D-alanine ligase">DADAL</a>/<a href="/wiki/Alanine_racemase" title="Alanine racemase">AR</a> inhibitors (<a href="/wiki/Cycloserine" title="Cycloserine">Cycloserine</a>)</li> <li><a href="/wiki/Bactoprenol" title="Bactoprenol">bactoprenol</a> inhibitors (<a href="/wiki/Bacitracin" title="Bacitracin">Bacitracin</a>)</li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li>Hydrolyze NAM-NAG <ul><li><a href="/wiki/Lysozyme" title="Lysozyme">lysozyme</a></li></ul></li> <li><a href="/wiki/Tyrothricin" title="Tyrothricin">Tyrothricin</a> <ul><li><a href="/wiki/Gramicidin" title="Gramicidin">Gramicidin</a></li> <li><a href="/wiki/Tyrocidine" title="Tyrocidine">Tyrocidine</a></li></ul></li> <li><a href="/wiki/Isoniazid" title="Isoniazid">Isoniazid</a><sup>#</sup></li> <li><a href="/wiki/Teixobactin" title="Teixobactin">Teixobactin</a></li></ul> </div></td></tr><tr><td class="navbox-abovebelow" colspan="2" style="background: transparent; padding: 0px;"><div><div class="hlist"> <ul><li><sup>#</sup><a href="/wiki/WHO_Model_List_of_Essential_Medicines" title="WHO Model List of Essential Medicines">WHO-EM</a></li> <li><sup>‡</sup><a href="/wiki/List_of_withdrawn_drugs" title="List of withdrawn drugs">Withdrawn</a> from market</li> <li><a href="/wiki/Clinical_trial" title="Clinical trial">Clinical trials</a>: <ul><li><sup>†</sup><a href="/wiki/Phases_of_clinical_research#Phase_III" title="Phases of clinical research">Phase III</a></li> <li><sup>§</sup>Never to phase III</li></ul></li></ul> </div></div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"></div><div role="navigation" class="navbox" aria-labelledby="Antibacterials_that_inhibit_nucleic_acid_(J01E,_J01M)" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231"><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Nucleic_acid_inhibitors" title="Template:Nucleic acid inhibitors"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Nucleic_acid_inhibitors" title="Template talk:Nucleic acid inhibitors"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Nucleic_acid_inhibitors" title="Special:EditPage/Template:Nucleic acid inhibitors"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Antibacterials_that_inhibit_nucleic_acid_(J01E,_J01M)" style="font-size:114%;margin:0 4em"><a href="/wiki/Antibiotics" class="mw-redirect" title="Antibiotics">Antibacterials</a> that <a href="/wiki/Nucleic_acid_inhibitor" title="Nucleic acid inhibitor">inhibit nucleic acid</a> (<a href="/wiki/ATC_code_J01#J01E" title="ATC code J01">J01E</a>, <a href="/wiki/ATC_code_J01#J01M" title="ATC code J01">J01M</a>)</div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Antifolate" title="Antifolate">Antifolates</a><br />(inhibit bacterial<br /><a href="/wiki/Purine_metabolism" title="Purine metabolism">purine metabolism</a>,<br />thereby inhibiting<br />DNA and RNA<br />synthesis)</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Dihydrofolate_reductase_inhibitor" title="Dihydrofolate reductase inhibitor">DHFR inhibitor</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/2,4-Diaminopyrimidine" title="2,4-Diaminopyrimidine">2,4-Diaminopyrimidine</a> <ul><li><a href="/wiki/Brodimoprim" title="Brodimoprim">Brodimoprim</a></li> <li><a href="/wiki/Iclaprim" title="Iclaprim">Iclaprim</a><sup>†</sup></li> <li><a href="/wiki/Ormetoprim" title="Ormetoprim">Ormetoprim</a></li> <li><a href="/wiki/Pyrimethamine" title="Pyrimethamine">Pyrimethamine</a><sup>#</sup></li> <li><a href="/wiki/Tetroxoprim" title="Tetroxoprim">Tetroxoprim</a></li> <li><a href="/wiki/Trimethoprim" title="Trimethoprim">Trimethoprim</a><sup>#</sup></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Sulfonamide_(medicine)" title="Sulfonamide (medicine)">Sulfonamides</a><br />(<a href="/wiki/Dihydropteroate_synthetase_inhibitor" class="mw-redirect" title="Dihydropteroate synthetase inhibitor">DHPS inhibitor</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Sulfonamide_(medicine)#Short-acting" title="Sulfonamide (medicine)">Short-acting</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Sulfisomidine" title="Sulfisomidine">Sulfaisodimidine</a></li> <li><a href="/wiki/Sulfamethizole" title="Sulfamethizole">Sulfamethizole</a></li> <li><a href="/wiki/Sulfadimidine" title="Sulfadimidine">Sulfadimidine</a></li> <li><a href="/wiki/Sulfapyridine" title="Sulfapyridine">Sulfapyridine</a> (<a href="/wiki/Sulfasalazine" title="Sulfasalazine">Sulfasalazine</a>)</li> <li><a href="/wiki/Sulfafurazole" title="Sulfafurazole">Sulfafurazole</a> (<a href="/w/index.php?title=Acetyl_sulfisoxazole&amp;action=edit&amp;redlink=1" class="new" title="Acetyl sulfisoxazole (page does not exist)">Acetyl sulfisoxazole</a>)</li> <li><a href="/wiki/Sulfanilamide" title="Sulfanilamide">Sulfanilamide</a> <ul><li><a href="/wiki/Prontosil" title="Prontosil">Prontosil</a></li></ul></li> <li><a href="/wiki/Sulfathiazole" title="Sulfathiazole">Sulfathiazole</a> (<a href="/wiki/Phthalylsulfathiazole" title="Phthalylsulfathiazole">Phthalylsulfathiazole</a>, <a href="/wiki/Succinylsulfathiazole" title="Succinylsulfathiazole">Succinylsulfathiazole</a>)</li> <li><a href="/wiki/Sulfathiourea" title="Sulfathiourea">Sulfathiourea</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Sulfonamide_(medicine)#Intermediate-acting" title="Sulfonamide (medicine)">Intermediate-acting</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Sulfamethoxazole" title="Sulfamethoxazole">Sulfamethoxazole</a></li> <li><a href="/wiki/Sulfadiazine" title="Sulfadiazine">Sulfadiazine</a><sup>#</sup></li> <li><a href="/wiki/Sulfamoxole" title="Sulfamoxole">Sulfamoxole</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Sulfonamide_(medicine)#Long-acting" title="Sulfonamide (medicine)">Long-acting</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Sulfadimethoxine" title="Sulfadimethoxine">Sulfadimethoxine</a></li> <li><a href="/wiki/Sulfadoxine" title="Sulfadoxine">Sulfadoxine</a></li> <li><a href="/wiki/Sulfalene" title="Sulfalene">Sulfalene</a></li> <li><a href="/wiki/Sulfametomidine" title="Sulfametomidine">Sulfametomidine</a></li> <li><a href="/wiki/Sulfametoxydiazine" title="Sulfametoxydiazine">Sulfametoxydiazine</a></li> <li><a href="/wiki/Sulfamethoxypyridazine" title="Sulfamethoxypyridazine">Sulfamethoxypyridazine</a></li> <li><a href="/wiki/Sulfaperin" title="Sulfaperin">Sulfaperin</a></li> <li><a href="/wiki/Sulfamerazine" title="Sulfamerazine">Sulfamerazine</a></li> <li><a href="/wiki/Sulfaphenazole" title="Sulfaphenazole">Sulfaphenazole</a></li> <li><a href="/wiki/Sulfamazone" title="Sulfamazone">Sulfamazone</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other/ungrouped</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Mafenide" title="Mafenide">Mafenide</a></li> <li><a href="/wiki/Sulfacetamide" title="Sulfacetamide">Sulfacetamide</a></li> <li><a href="/w/index.php?title=Sulfaclozine&amp;action=edit&amp;redlink=1" class="new" title="Sulfaclozine (page does not exist)">Sulfaclozine</a></li> <li><a href="/wiki/Sulfadicramide" title="Sulfadicramide">Sulfadicramide</a></li> <li><a href="/wiki/Sulfaguanidine" title="Sulfaguanidine">Sulfaguanidine</a></li> <li><a href="/wiki/Sulfametrole" title="Sulfametrole">Sulfametrole</a></li> <li><a href="/wiki/Sulfanitran" title="Sulfanitran">Sulfanitran</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Combinations</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Trimethoprim/sulfamethoxazole" title="Trimethoprim/sulfamethoxazole">Trimethoprim/sulfamethoxazole</a><sup>#</sup></li> <li><a href="/wiki/Sulfadimethoxine#with_ormetoprim" title="Sulfadimethoxine">Ormetoprim/sulfadimethoxine</a></li> <li><a href="/w/index.php?title=Pyrimethamine/dapsone&amp;action=edit&amp;redlink=1" class="new" title="Pyrimethamine/dapsone (page does not exist)">Pyrimethamine/dapsone</a></li> <li><a href="/w/index.php?title=Pyrimethamine/sulfadoxine&amp;action=edit&amp;redlink=1" class="new" title="Pyrimethamine/sulfadoxine (page does not exist)">Pyrimethamine/sulfadoxine</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other DHPS inhibitors</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Acediasulfone" title="Acediasulfone">Acediasulfone</a></li> <li><a href="/wiki/Dapsone" title="Dapsone">Dapsone</a></li> <li><a href="/wiki/Solasulfone" title="Solasulfone">Solasulfone</a></li> <li><a href="/wiki/Sulfoxone" title="Sulfoxone">Sulfoxone</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Quinolone_antibiotic" title="Quinolone antibiotic">Quinolones</a><br />(inhibit bacterial<br /><a href="/wiki/Topoisomerase_inhibitor" title="Topoisomerase inhibitor">topoisomerase</a><br />and/or <a href="/wiki/DNA_gyrase" title="DNA gyrase">DNA gyrase</a>,<br />thereby inhibiting<br /><a href="/wiki/DNA_replication" title="DNA replication">DNA replication</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Quinolone_antibiotic#First_generation" title="Quinolone antibiotic">1st generation</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Cinoxacin" title="Cinoxacin">Cinoxacin</a><sup>‡</sup></li> <li><a href="/wiki/Flumequine" title="Flumequine">Flumequine</a><sup>‡</sup></li> <li><a href="/wiki/Nalidixic_acid" title="Nalidixic acid">Nalidixic acid</a><sup>‡</sup></li> <li><a href="/wiki/Oxolinic_acid" title="Oxolinic acid">Oxolinic acid</a><sup>‡</sup></li> <li><a href="/wiki/Pipemidic_acid" title="Pipemidic acid">Pipemidic acid</a><sup>‡</sup></li> <li><a href="/wiki/Piromidic_acid" title="Piromidic acid">Piromidic acid</a><sup>‡</sup></li> <li><a href="/wiki/Rosoxacin" title="Rosoxacin">Rosoxacin</a><sup>‡</sup></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Quinolone_antibiotic" title="Quinolone antibiotic">Fluoroquinolones</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Quinolone_antibiotic#Second_generation" title="Quinolone antibiotic">2nd generation</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Ciprofloxacin" title="Ciprofloxacin">Ciprofloxacin</a><sup>#</sup></li> <li><a href="/wiki/Ofloxacin" title="Ofloxacin">Ofloxacin</a></li> <li><a href="/wiki/Enoxacin" title="Enoxacin">Enoxacin</a><sup>‡</sup></li> <li><a href="/wiki/Fleroxacin" title="Fleroxacin">Fleroxacin</a><sup>‡</sup></li> <li><a href="/wiki/Lomefloxacin" title="Lomefloxacin">Lomefloxacin</a><sup>‡</sup></li> <li><a href="/wiki/Nadifloxacin" title="Nadifloxacin">Nadifloxacin</a><sup>‡</sup>/<a href="/wiki/Levonadifloxacin" title="Levonadifloxacin">Levonadifloxacin</a>/<a href="/wiki/Alalevonadifloxacin" title="Alalevonadifloxacin">Alalevonadifloxacin</a></li> <li><a href="/wiki/Norfloxacin" title="Norfloxacin">Norfloxacin</a><sup>‡</sup></li> <li><a href="/wiki/Pefloxacin" title="Pefloxacin">Pefloxacin</a><sup>‡</sup></li> <li><a href="/wiki/Rufloxacin" title="Rufloxacin">Rufloxacin</a><sup>‡</sup></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Quinolone_antibiotic#Third_generation" title="Quinolone antibiotic">3rd generation</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Levofloxacin" title="Levofloxacin">Levofloxacin</a><sup>#</sup></li> <li><a href="/wiki/Balofloxacin" title="Balofloxacin">Balofloxacin</a><sup>‡</sup></li> <li><a href="/wiki/Grepafloxacin" title="Grepafloxacin">Grepafloxacin</a><sup>‡</sup></li> <li><a href="/wiki/Pazufloxacin" title="Pazufloxacin">Pazufloxacin</a><sup>‡</sup></li> <li><a href="/wiki/Sparfloxacin" title="Sparfloxacin">Sparfloxacin</a><sup>‡</sup></li> <li><a href="/wiki/Temafloxacin" title="Temafloxacin">Temafloxacin</a><sup>‡</sup></li> <li><a href="/wiki/Tosufloxacin" title="Tosufloxacin">Tosufloxacin</a><sup>‡</sup></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Quinolone_antibiotic#Fourth_generation" title="Quinolone antibiotic">4th generation</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Besifloxacin" title="Besifloxacin">Besifloxacin</a></li> <li><a href="/wiki/Delafloxacin" title="Delafloxacin">Delafloxacin</a></li> <li><a href="/wiki/Gatifloxacin" title="Gatifloxacin">Gatifloxacin</a></li> <li><a href="/wiki/Finafloxacin" title="Finafloxacin">Finafloxacin</a></li> <li><a href="/wiki/Gemifloxacin" title="Gemifloxacin">Gemifloxacin</a></li> <li><a href="/wiki/Moxifloxacin" title="Moxifloxacin">Moxifloxacin</a><sup>#</sup></li> <li><a href="/wiki/Clinafloxacin" title="Clinafloxacin">Clinafloxacin</a><sup>†</sup></li> <li><a href="/wiki/Garenoxacin" title="Garenoxacin">Garenoxacin</a><sup>‡</sup></li> <li><a href="/wiki/Prulifloxacin" title="Prulifloxacin">Prulifloxacin</a><sup>‡</sup></li> <li><a href="/wiki/Sitafloxacin" title="Sitafloxacin">Sitafloxacin</a><sup>‡</sup></li> <li><a href="/wiki/Trovafloxacin" title="Trovafloxacin">Trovafloxacin</a><sup>‡</sup>/<a href="/wiki/Alatrofloxacin" title="Alatrofloxacin">Alatrofloxacin</a><sup>‡</sup></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Quinolone_antibiotic#Veterinary_use" title="Quinolone antibiotic">Veterinary</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Danofloxacin" title="Danofloxacin">Danofloxacin</a></li> <li><a href="/wiki/Difloxacin" title="Difloxacin">Difloxacin</a></li> <li><a href="/wiki/Enrofloxacin" title="Enrofloxacin">Enrofloxacin</a></li> <li><a href="/wiki/Ibafloxacin" title="Ibafloxacin">Ibafloxacin</a></li> <li><a href="/wiki/Marbofloxacin" title="Marbofloxacin">Marbofloxacin</a></li> <li><a href="/wiki/Orbifloxacin" title="Orbifloxacin">Orbifloxacin</a></li> <li><a href="/wiki/Pradofloxacin" title="Pradofloxacin">Pradofloxacin</a></li> <li><a href="/wiki/Sarafloxacin" title="Sarafloxacin">Sarafloxacin</a><sup>‡</sup></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Newer non-fluorinated</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Nemonoxacin" title="Nemonoxacin">Nemonoxacin</a></li> <li><a href="/wiki/Ozenoxacin" title="Ozenoxacin">Ozenoxacin</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Related (<a href="/wiki/DNA_gyrase" title="DNA gyrase">DG</a>)</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Aminocoumarin" title="Aminocoumarin">Aminocoumarins</a>: <a href="/wiki/Novobiocin" title="Novobiocin">Novobiocin</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Anaerobic_organism" title="Anaerobic organism">Anaerobic</a> DNA<br /><a href="/wiki/Nucleic_acid_inhibitor#DNA_inhibitors" title="Nucleic acid inhibitor">inhibitors</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th id="Nitroimidazole_derivatives" scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Nitroimidazole" title="Nitroimidazole">Nitroimidazole</a> derivatives</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Secnidazole" title="Secnidazole">Secnidazole</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/RNA" title="RNA">RNA</a> synthesis</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Rifamycin" title="Rifamycin">Rifamycins</a>/<br /><a href="/wiki/RNA-dependent_RNA_polymerase" title="RNA-dependent RNA polymerase">RNA polymerase</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Rifampicin" title="Rifampicin">Rifampicin</a><sup>#</sup></li> <li><a href="/wiki/Rifabutin" title="Rifabutin">Rifabutin</a><sup>#</sup></li> <li><a href="/wiki/Rifapentine" title="Rifapentine">Rifapentine</a><sup>#</sup></li> <li><a href="/wiki/Rifaximin" title="Rifaximin">Rifaximin</a></li> <li><a href="/wiki/Rifalazil" title="Rifalazil">Rifalazil</a><sup>§</sup></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Lipiarmycin" class="mw-redirect" title="Lipiarmycin">Lipiarmycins</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Fidaxomicin" title="Fidaxomicin">Fidaxomicin</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><td class="navbox-abovebelow" colspan="2" style="background: transparent; padding: 0px;"><div><div class="hlist"> <ul><li><sup>#</sup><a href="/wiki/WHO_Model_List_of_Essential_Medicines" title="WHO Model List of Essential Medicines">WHO-EM</a></li> <li><sup>‡</sup><a href="/wiki/List_of_withdrawn_drugs" title="List of withdrawn drugs">Withdrawn</a> from market</li> <li><a href="/wiki/Clinical_trial" title="Clinical trial">Clinical trials</a>: <ul><li><sup>†</sup><a href="/wiki/Phases_of_clinical_research#Phase_III" title="Phases of clinical research">Phase III</a></li> <li><sup>§</sup>Never to phase III</li></ul></li></ul> </div></div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Antibacterials:_others_(J01X,_D06AX)" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231"><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Other_antibacterials" title="Template:Other antibacterials"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Other_antibacterials" title="Template talk:Other antibacterials"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Other_antibacterials" title="Special:EditPage/Template:Other antibacterials"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Antibacterials:_others_(J01X,_D06AX)" style="font-size:114%;margin:0 4em"><a href="/wiki/Antibiotics" class="mw-redirect" title="Antibiotics">Antibacterials</a>: others (<a href="/wiki/ATC_code_J01#J01X" title="ATC code J01">J01X</a>, <a href="/wiki/ATC_code_D06#D06AX" title="ATC code D06">D06AX</a>)</div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Glycopeptide_antibiotic" title="Glycopeptide antibiotic">Glycopeptides</a><br /><a href="/wiki/Lipoglycopeptide" title="Lipoglycopeptide">Lipoglycopeptides</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Avoparcin" title="Avoparcin">Avoparcin</a></li> <li><a href="/wiki/Corbomycin" title="Corbomycin">Corbomycin</a></li> <li><a href="/wiki/Dalbavancin" title="Dalbavancin">Dalbavancin</a></li> <li><a href="/wiki/Oritavancin" title="Oritavancin">Oritavancin</a></li> <li><a href="/wiki/Ristocetin" title="Ristocetin">Ristocetin</a></li> <li><a href="/wiki/Teicoplanin" title="Teicoplanin">Teicoplanin</a></li> <li><a href="/wiki/Telavancin" title="Telavancin">Telavancin</a></li> <li><a href="/wiki/Vancomycin" title="Vancomycin">Vancomycin</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Polymyxin" title="Polymyxin">Polymyxins</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Colistin" title="Colistin">Colistin</a></li> <li><a href="/wiki/Polymyxin_B" title="Polymyxin B">Polymyxin B</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Steroid" title="Steroid">Steroid</a> antibacterials</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Fusidic_acid" title="Fusidic acid">Fusidic acid</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Imidazole" title="Imidazole">Imidazole</a> derivatives</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Metronidazole" title="Metronidazole">Metronidazole</a></li> <li><a href="/wiki/Ornidazole" title="Ornidazole">Ornidazole</a></li> <li><a href="/wiki/Tinidazole" title="Tinidazole">Tinidazole</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Pleuromutilin" title="Pleuromutilin">Pleuromutilins</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Azamulin" title="Azamulin">Azamulin</a></li> <li><a href="/wiki/Lefamulin" title="Lefamulin">Lefamulin</a></li> <li><a href="/wiki/Retapamulin" title="Retapamulin">Retapamulin</a></li> <li><a href="/wiki/Tiamulin" title="Tiamulin">Tiamulin</a></li> <li><a href="/wiki/Valnemulin" title="Valnemulin">Valnemulin</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Nitrofuran" title="Nitrofuran">Nitrofuran</a> derivatives</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Furazolidone" title="Furazolidone">Furazolidone</a></li> <li><a href="/wiki/Nifuroxazide" title="Nifuroxazide">Nifuroxazide</a></li> <li><a href="/wiki/Nifurtoinol" title="Nifurtoinol">Nifurtoinol</a></li> <li><a href="/wiki/Nifurzide" title="Nifurzide">Nifurzide</a></li> <li><a href="/wiki/Nitrofurantoin" title="Nitrofurantoin">Nitrofurantoin</a></li> <li><a href="/wiki/Nitrofurazone" title="Nitrofurazone">Nitrofurazone</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other antibacterials</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Bacitracin" title="Bacitracin">Bacitracin</a></li> <li><a href="/wiki/Clofoctol" title="Clofoctol">Clofoctol</a></li> <li><a href="/wiki/Daptomycin" title="Daptomycin">Daptomycin</a></li> <li><a href="/wiki/Fosfomycin" title="Fosfomycin">Fosfomycin</a></li> <li><a href="/wiki/Furaltadone" title="Furaltadone">Furaltadone</a></li> <li><a href="/wiki/Lefamulin" title="Lefamulin">Lefamulin</a></li> <li><a href="/wiki/Linezolid" title="Linezolid">Linezolid</a></li> <li><a href="/wiki/Mandelic_acid" title="Mandelic acid">Mandelic acid</a></li> <li><a href="/wiki/Hexamethylenetetramine" title="Hexamethylenetetramine">Methenamine</a></li> <li><a href="/wiki/Nitroxoline" title="Nitroxoline">Nitroxoline</a></li> <li><a href="/wiki/Novobiocin" title="Novobiocin">Novobiocin</a></li> <li><a href="/wiki/Spectinomycin" title="Spectinomycin">Spectinomycin</a></li> <li><a href="/wiki/Tedizolid" title="Tedizolid">Tedizolid</a></li> <li><a href="/wiki/Xibornol" title="Xibornol">Xibornol</a></li></ul> </div></td></tr></tbody></table></div></div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Concepts_in_infectious_disease_(Outline)" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231"><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Concepts_in_infectious_disease" title="Template:Concepts in infectious disease"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Concepts_in_infectious_disease" title="Template talk:Concepts in infectious disease"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Concepts_in_infectious_disease" title="Special:EditPage/Template:Concepts in infectious disease"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Concepts_in_infectious_disease_(Outline)" style="font-size:114%;margin:0 4em">Concepts in <a href="/wiki/Infection" title="Infection">infectious disease</a> (<a href="/wiki/Outline_of_infectious_disease_concepts" title="Outline of infectious disease concepts">Outline</a>)</div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%">Determinants</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;text-align:left;"><a href="/wiki/Pathogen" title="Pathogen">Agent</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Biofilm#Infectious_diseases" title="Biofilm">Biofilm</a></li> <li><a href="/wiki/Germ_theory_of_disease" title="Germ theory of disease">Germ theory of disease</a></li> <li><a href="/wiki/Infectivity" title="Infectivity">Infectivity</a> <ul><li><a href="/wiki/Minimal_infective_dose" title="Minimal infective dose">Infectious dose</a></li></ul></li> <li><a href="/wiki/Pathogenicity" class="mw-redirect" title="Pathogenicity">Pathogenicity</a> <ul><li><a href="/wiki/Attack_rate" title="Attack rate">Attack rate</a></li></ul></li> <li><a href="/wiki/Quorum_sensing" title="Quorum sensing">Quorum sensing</a></li> <li><a href="/wiki/Virulence" title="Virulence">Virulence</a> <ul><li><a href="/wiki/Endotoxin" class="mw-redirect" title="Endotoxin">Endotoxin</a></li> <li><a href="/wiki/Exotoxin" title="Exotoxin">Exotoxin</a></li> <li><a href="/wiki/Case_fatality_rate" title="Case fatality rate">Case fatality rate</a></li> <li><a href="/wiki/Virulence_factor" title="Virulence factor">factors</a></li></ul></li> <li><a href="/wiki/Antimicrobial_resistance" title="Antimicrobial resistance">Antimicrobial resistance</a> <ul><li><a href="/wiki/Drug_resistance" title="Drug resistance">Drug resistance</a></li> <li><a href="/wiki/Horizontal_gene_transfer" title="Horizontal gene transfer">Horizontal gene transfer</a></li> <li><a href="/wiki/Multidrug-resistant_bacteria" title="Multidrug-resistant bacteria">Multidrug-resistant bacteria</a></li></ul></li> <li><a href="/wiki/Host_tropism" title="Host tropism">Host tropism</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;text-align:left;"><a href="/wiki/Host_(biology)" title="Host (biology)">Host</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Burn#Complications" title="Burn">Burn</a></li> <li><a href="/wiki/Comorbidity" title="Comorbidity">Comorbidity</a></li> <li><a href="/wiki/Diabetic_foot_infection" title="Diabetic foot infection">Diabetes</a></li> <li><a href="/wiki/Host%E2%80%93pathogen_interaction" title="Host–pathogen interaction">Host–pathogen interaction</a></li> <li><a href="/wiki/Immune_response" title="Immune response">Immune response</a> <ul><li><a href="/wiki/Immunodeficiency" title="Immunodeficiency">Immunodeficiency</a></li> <li><a href="/wiki/Immunosuppression" title="Immunosuppression">Immunosuppression</a></li></ul></li> <li><a href="/wiki/Microbial_symbiosis_and_immunity" title="Microbial symbiosis and immunity">Microbiome health</a></li> <li><a href="/wiki/Opportunistic_infection" title="Opportunistic infection">Opportunistic infection</a></li> <li><a href="/wiki/Risk_of_infection" title="Risk of infection">Risk of infection</a></li> <li><a href="/wiki/Susceptible_individual" title="Susceptible individual">Susceptible individual</a> <ul><li>Age</li> <li>Gender</li> <li>Nutrition status</li> <li>Vaccination status</li> <li>Genetic predisposition</li> <li>Behavioral/lifestyle factors <ul><li><a href="/wiki/Health_effects_of_tobacco#infection" title="Health effects of tobacco">Smoking</a></li></ul></li> <li>Pregnancy</li> <li>Stress levels</li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;text-align:left;"><a href="/wiki/Environmental_epidemiology" title="Environmental epidemiology">Environment</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/WASH" title="WASH">Access to water, sanitation and hygiene</a></li> <li>Air quality</li> <li>Biodiversity loss</li> <li><a href="/wiki/Climate_change_and_infectious_diseases" title="Climate change and infectious diseases">Climate change</a></li> <li>Climate zones <ul><li><a href="/wiki/El_Ni%C3%B1o#Health_and_social_impacts" class="mw-redirect" title="El Niño">El Niño</a></li> <li><a href="/wiki/Tropical_disease#Relation_of_climate_to_tropical_diseases" title="Tropical disease">Tropical diseases</a></li></ul></li> <li><a href="/wiki/Globalization_and_disease" title="Globalization and disease">Commerce</a></li> <li><a href="/wiki/Deforestation#Health_effects" title="Deforestation">Deforestation</a></li> <li><a href="/wiki/Disease_ecology" title="Disease ecology">Ecology</a></li> <li><a href="/wiki/Humidity#Human_health" title="Humidity">Humidity</a></li> <li><a href="/wiki/Needle_sharing" title="Needle sharing">Injection drug use</a></li> <li>Natural disaster <ul><li><a href="/wiki/Flood#Health_effects" title="Flood">Flood</a></li></ul></li> <li><a href="/wiki/Zoonosis#Farming,_ranching_and_animal_husbandry" title="Zoonosis">Poultry and livestock</a></li> <li><a href="/wiki/Diseases_of_poverty" title="Diseases of poverty">Poverty</a></li> <li><a href="/wiki/Travel_medicine" title="Travel medicine">Travel</a></li> <li><a href="/wiki/Urbanization#Infections" title="Urbanization">Urbanization</a></li> <li><a href="/wiki/Vector_control" title="Vector control">Vector control</a></li> <li><a href="/wiki/Conflict_epidemiology" title="Conflict epidemiology">War and conflict</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Transmission_(medicine)" class="mw-redirect" title="Transmission (medicine)">Transmission</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th id="Basic_concepts" scope="row" class="navbox-group" style="width:1%;text-align:left;">Basic <br />concepts</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Asymptomatic_carrier" title="Asymptomatic carrier">Asymptomatic carrier</a></li> <li><a href="/wiki/Infection#Pathophysiology" title="Infection">Chain of infection</a></li> <li><a href="/wiki/Fomite" title="Fomite">Fomite</a></li> <li><a href="/wiki/Host_(biology)" title="Host (biology)">Host</a></li> <li><a href="/wiki/Incubation_period" title="Incubation period">Incubation period</a></li> <li><a href="/wiki/Index_case" title="Index case">Index case</a></li> <li><a href="/wiki/Infectious_period" title="Infectious period">Infectious period</a></li> <li><a href="/wiki/Latent_period_(epidemiology)" title="Latent period (epidemiology)">Latent period</a></li> <li><a href="/wiki/Natural_reservoir" title="Natural reservoir">Natural reservoir</a></li> <li><a href="/wiki/Opportunistic_infection" title="Opportunistic infection">Opportunistic infection</a></li> <li><a href="/wiki/Subclinical_infection" title="Subclinical infection">Silent/Subclinical infection</a></li> <li><a href="/wiki/Superinfection" title="Superinfection">Superinfection</a></li> <li><a href="/wiki/Super-spreader" class="mw-redirect" title="Super-spreader">Super-spreader</a></li> <li><a href="/wiki/Viral_load" title="Viral load">Viral load</a></li> <li><a href="/wiki/Window_period" title="Window period">Window period</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;text-align:left;">Modes</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;text-align:left;">Endogenous</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li>Endogenous overgrowth</li> <li><a href="/wiki/Human_microbiome#Disease_and_death" title="Human microbiome">Normal flora overgrowth</a></li> <li><a href="/wiki/Virus_latency" title="Virus latency">Endogenous reactivation</a></li> <li>Microbial translocation</li> <li>Endogenous seeding</li> <li><a href="/wiki/Biofilm" title="Biofilm">Biofilm</a> formation</li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;text-align:left;">Exogenous</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;text-align:left;"><a href="/wiki/Cross-species_transmission" title="Cross-species transmission">Cross-species</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Spillover_infection" title="Spillover infection">Spillover infection</a></li> <li><a href="/wiki/Vector_(epidemiology)" class="mw-redirect" title="Vector (epidemiology)">Vector</a></li> <li><a href="/wiki/Zoonosis" title="Zoonosis">Zoonosis</a></li> <li><a href="/wiki/Reverse_zoonosis" title="Reverse zoonosis">Reverse zoonosis</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;text-align:left;"><a href="/wiki/Human-to-human_transmission" title="Human-to-human transmission">Human-to-human</a><br />/Cross-infection</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Contagious_disease" title="Contagious disease">Contagious disease</a></li> <li>Source <ul><li><a href="/wiki/Hospital-acquired_infection" title="Hospital-acquired infection">Nosocomial/Hospital</a></li> <li><a href="/wiki/Iatrogenesis" title="Iatrogenesis">Iatrogenic/Medical care</a></li></ul></li> <li>Generational difference <ul><li><a href="/wiki/Vertically_transmitted_infection" title="Vertically transmitted infection">Vertical/Congenital</a> <ul><li>Prenatal</li> <li>Perinatal</li> <li><a href="/wiki/Neonatal_infection" title="Neonatal infection">Neonatal</a></li></ul></li> <li><a href="/wiki/Transmission_(medicine)#Horizontal_transmission" class="mw-redirect" title="Transmission (medicine)">Horizontal</a></li></ul></li> <li><a href="/wiki/Breakthrough_infection" title="Breakthrough infection">Breakthrough infection</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;text-align:left;">Environment-<br />to-human</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Sapronosis" title="Sapronosis">Sapronosis</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;text-align:left;">Routes</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;text-align:left;">Respiratory</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Airborne_disease" class="mw-redirect" title="Airborne disease">Air</a></li> <li><a href="/wiki/Bioaerosol" title="Bioaerosol">Bioaerosol</a> <ul><li><a href="/wiki/Aerosol-generating_procedure" title="Aerosol-generating procedure">Aerosol-generating procedure</a></li></ul></li> <li><a href="/wiki/Dental_aerosol" title="Dental aerosol">Dental aerosol</a></li> <li><a href="/wiki/Respiratory_droplet#Role_in_disease_transmission" title="Respiratory droplet">Respiratory droplet</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;text-align:left;">Linked to<br />Vascular system</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Blood-borne_disease" title="Blood-borne disease">Blood-borne disease</a></li> <li>Percutaneous inoculation <ul><li><a href="/wiki/Injection_(medicine)#Infection" title="Injection (medicine)">Injection site</a></li> <li><a href="/wiki/Intravenous_therapy#Infection_and_inflammation" title="Intravenous therapy">Intravenous line</a></li> <li>Insect bite</li> <li><a href="/wiki/Animal_bite#Infection" title="Animal bite">Animal bite</a></li></ul></li> <li>Surgical intervention <ul><li><a href="/wiki/Postoperative_wounds#Infection" title="Postoperative wounds">Postoperative wound</a></li> <li><a href="/wiki/Surgical_site_infection" class="mw-redirect" title="Surgical site infection">Surgical site infection</a></li></ul></li> <li>Vector-borne <ul><li><a href="/wiki/Mosquito-borne_disease" title="Mosquito-borne disease">Mosquito</a></li> <li><a href="/wiki/Tick-borne_disease" title="Tick-borne disease">Tick</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;text-align:left;">Gastrointestinal</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Foodborne_illness" title="Foodborne illness">Food</a> <ul><li><a href="/wiki/Food_contaminant" title="Food contaminant">Contamination</a></li></ul></li> <li><a href="/wiki/Breastfeeding_contraindications" title="Breastfeeding contraindications">Breastmilk</a></li> <li><a href="/wiki/Waterborne_disease" title="Waterborne disease">Water</a></li> <li><a href="/wiki/Fecal%E2%80%93oral_route" title="Fecal–oral route">Feces</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;text-align:left;">Cutaneous</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Burn#Complications" title="Burn">Burn</a></li> <li><a href="/wiki/Fomite" title="Fomite">Fomite</a></li> <li><a href="/wiki/Soil-transmitted_helminthiasis" title="Soil-transmitted helminthiasis">Soil</a></li> <li>Open <a href="/wiki/Wound" title="Wound">wound</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;text-align:left;">Genitourinary</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Sexually_transmitted_infection" title="Sexually transmitted infection">Sex</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;text-align:left;">Trans-placental</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li>Prenatal</li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;text-align:left;">Cervico-vaginal</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li>Perinatal</li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;text-align:left;">Other</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Eye_disease" title="Eye disease">Ocular (Eye) mucosal membrane</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table><div></div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;text-align:left;"><a href="/wiki/Mathematical_modelling_of_infectious_disease" class="mw-redirect" title="Mathematical modelling of infectious disease">Modelling</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Agent-based_model_in_biology#Bacteria_aggregation_leading_to_biofilm_formation" title="Agent-based model in biology">Agent-based model</a></li> <li><a href="/wiki/Animal_disease_model" title="Animal disease model">Animal disease model</a></li> <li><a href="/wiki/Attack_rate" title="Attack rate">Attack rate</a></li> <li><a href="/wiki/Basic_reproduction_number" title="Basic reproduction number">Basic reproduction number</a></li> <li><a href="/wiki/Compartmental_models_in_epidemiology" title="Compartmental models in epidemiology">Compartmental models in epidemiology</a></li> <li><a href="/wiki/Critical_community_size" title="Critical community size">Critical community size</a></li> <li><a href="/wiki/Force_of_infection" title="Force of infection">Force of infection</a></li> <li><a href="/wiki/Herd_immunity" title="Herd immunity">Herd immunity</a></li> <li><a href="/wiki/Infection_rate" title="Infection rate">Infection rate</a></li> <li><a href="/wiki/Artificial_intelligence_in_healthcare" title="Artificial intelligence in healthcare">Machine learning</a></li> <li><a href="/wiki/Multiplicity_of_infection" title="Multiplicity of infection">Multiplicity of infection</a></li> <li><a href="/wiki/Serial_interval" title="Serial interval">Serial interval</a></li> <li><a href="/wiki/WAIFW_matrix" title="WAIFW matrix">WAIFW matrix</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;text-align:left;">Occurrence<br />in population</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Disease_cluster" title="Disease cluster">Cluster</a></li> <li><a href="/wiki/Endemic_(epidemiology)" title="Endemic (epidemiology)">Endemic</a></li> <li><a href="/wiki/Epidemic" title="Epidemic">Epidemic</a> <ul><li><a href="/wiki/Epidemic_curve" title="Epidemic curve">Curve</a></li> <li><a href="/wiki/Farr%27s_laws" title="Farr&#39;s laws">Farr's laws</a></li></ul></li> <li><a href="/wiki/Holoendemic" title="Holoendemic">Holoendemic</a></li> <li><a href="/wiki/Hyperendemic" title="Hyperendemic">Hyperendemic</a></li> <li><a href="/wiki/Incidence_(epidemiology)" title="Incidence (epidemiology)">Incidence</a></li> <li><a href="/wiki/Inequality_in_disease" title="Inequality in disease">Inequality</a></li> <li><a href="/wiki/Mesoendemic" class="mw-redirect" title="Mesoendemic">Mesoendemic</a></li> <li><a href="/wiki/Disease_outbreak" title="Disease outbreak">Outbreak</a></li> <li><a href="/wiki/Pandemic" title="Pandemic">Pandemic</a></li> <li><a href="/wiki/Prevalence" title="Prevalence">Prevalence</a></li> <li><a href="/wiki/Epidemic#Seasonality" title="Epidemic">Seasonality</a></li> <li><a href="/wiki/Spatial_epidemiology" title="Spatial epidemiology">Geographic distribution</a></li> <li><a href="/wiki/Sporadic_disease" title="Sporadic disease">Sporadic</a></li> <li><a href="/wiki/Syndemic" title="Syndemic">Syndemic</a></li> <li><a href="/wiki/Twindemic" title="Twindemic">Twindemic</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Anatomical <br />location</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li>Respiratory <ul><li><a href="/wiki/Upper_respiratory_tract_infection" title="Upper respiratory tract infection">Ear-Nose-Throat/Upper respiratory tract</a></li> <li><a href="/wiki/Lower_respiratory_tract_infection" title="Lower respiratory tract infection">Chest/Lower respiratory tract</a></li></ul></li> <li><a href="/wiki/Gastrointestinal_infection" class="mw-redirect" title="Gastrointestinal infection">Gastrointestinal</a> <ul><li><a href="/wiki/Intestinal_infectious_diseases" title="Intestinal infectious diseases">Intestinal</a></li></ul></li> <li>Genitourinary</li> <li>Nervous system</li> <li><a href="/wiki/Skin_infection" title="Skin infection">Skin</a></li> <li>Soft tissue</li> <li><a href="/wiki/Bone_infection" class="mw-redirect" title="Bone infection">Bone</a></li> <li><a href="/wiki/Joint_infection" class="mw-redirect" title="Joint infection">Joint</a></li> <li>Cardiovascular</li> <li><a href="/wiki/Systemic_disease" title="Systemic disease">Systemic/Generalized</a></li> <li><a href="/wiki/Sepsis" title="Sepsis">Blood</a></li> <li><a href="/wiki/Odontogenic_infection" title="Odontogenic infection">Tooth</a></li> <li><a href="/wiki/Mouth_infection" title="Mouth infection">Mouth</a></li> <li><a href="/wiki/Intra-amniotic_infection" class="mw-redirect" title="Intra-amniotic infection">Fetus</a></li> <li>Eye</li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Infection_prevention_and_control" title="Infection prevention and control">Prevention<br />and Control<br />measures</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;text-align:left;">Pharmaceutical</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a class="mw-selflink selflink">Antibiotic</a> <ul><li><a href="/wiki/Antibiotic_prophylaxis" title="Antibiotic prophylaxis">prophylactic</a></li></ul></li> <li><a href="/wiki/Antifungal" title="Antifungal">Antifungal</a></li> <li><a href="/wiki/Anthelmintic" title="Anthelmintic">Anthelmintic</a> <ul><li><a href="/wiki/Ascaricide" title="Ascaricide">Ascaricide</a></li></ul></li> <li><a href="/wiki/Antimicrobial" title="Antimicrobial">Antimicrobial</a> <ul><li><a href="/wiki/Antimicrobial_stewardship" title="Antimicrobial stewardship">Antimicrobial stewardship</a></li></ul></li> <li><a href="/wiki/Antiseptic" title="Antiseptic">Antiseptic</a></li> <li><a href="/wiki/Antiviral_drug" title="Antiviral drug">Antiviral</a></li> <li><a href="/wiki/Asepsis" title="Asepsis">Asepsis</a></li> <li><a href="/wiki/Combination_therapy" title="Combination therapy">Combination</a></li> <li><a href="/wiki/Pharmacovigilance" title="Pharmacovigilance">Drug safety</a></li> <li><a href="/wiki/Immunization" title="Immunization">Immunization</a></li> <li><a href="/wiki/Immunotherapy" title="Immunotherapy">Immunotherapy</a> <ul><li><a href="/wiki/Monoclonal_antibody_therapy" title="Monoclonal antibody therapy">Monoclonal antibody therapy</a></li></ul></li> <li><a href="/wiki/Inoculation" title="Inoculation">Inoculation</a></li> <li><a href="/wiki/Phage_therapy" title="Phage therapy">Phage therapy</a></li> <li><a href="/wiki/Pre-exposure_prophylaxis" title="Pre-exposure prophylaxis">Pre-exposure prophylaxis</a></li> <li><a href="/wiki/Post-exposure_prophylaxis" title="Post-exposure prophylaxis">Post-exposure prophylaxis</a></li> <li><a href="/wiki/Drug_repositioning" title="Drug repositioning">Repurposed drugs</a></li> <li><a href="/wiki/Vaccination" title="Vaccination">Vaccination</a> <ul><li><a href="/wiki/Vaccine_efficacy" title="Vaccine efficacy">efficacy/effectiveness</a></li> <li><a href="/wiki/Booster_dose" title="Booster dose">booster</a></li> <li><a href="/wiki/Vaccine_resistance" title="Vaccine resistance">resistance</a></li> <li><a href="/wiki/Vaccine-preventable_disease" title="Vaccine-preventable disease">Vaccine-preventable disease</a></li> <li><a href="/wiki/Ring_vaccination" title="Ring vaccination">Ring vaccination</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;text-align:left;"><a href="/wiki/Non-pharmaceutical_intervention_(epidemiology)" title="Non-pharmaceutical intervention (epidemiology)">Non-<br />pharmaceutical</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Contact_tracing" title="Contact tracing">Contact tracing</a></li> <li><a href="/wiki/Cordon_sanitaire_(medicine)" title="Cordon sanitaire (medicine)">Cordon sanitaire</a></li> <li><a href="/wiki/Disease_surveillance" title="Disease surveillance">Disease surveillance</a></li> <li><a href="/wiki/Disinfectant" title="Disinfectant">Disinfection</a></li> <li><a href="/wiki/Flattening_the_curve" title="Flattening the curve">Flattening the curve</a></li> <li><a href="/wiki/Hygiene" title="Hygiene">Hygiene</a> <ul><li><a href="/wiki/Food_safety" title="Food safety">Food hygiene</a></li> <li><a href="/wiki/Hand_washing" title="Hand washing">Hand washing</a></li> <li><a href="/wiki/Medical_glove" title="Medical glove">Gloves</a></li></ul></li> <li><a href="/wiki/Isolation_(health_care)" title="Isolation (health care)">Isolation</a> <ul><li><a href="/wiki/Barrier_nursing" title="Barrier nursing">Barrier nursing</a></li></ul></li> <li><a href="/wiki/Stay-at-home_order" title="Stay-at-home order">Lockdown</a></li> <li><a href="/wiki/Notifiable_disease" title="Notifiable disease">Notification</a> <ul><li><a href="/wiki/List_of_notifiable_diseases" title="List of notifiable diseases">list</a></li></ul></li> <li><a href="/wiki/Protective_sequestration" title="Protective sequestration">Protective sequestration</a></li> <li><a href="/wiki/Public_health" title="Public health">Public health</a> <ul><li><a href="/wiki/Community_health" title="Community health">Community health</a> services</li> <li><a href="/wiki/Health_communication" title="Health communication">Health communication</a></li> <li><a href="/wiki/Health_education" title="Health education">Health education</a></li></ul></li> <li><a href="/wiki/Outbreak_response" title="Outbreak response">Outbreak response</a></li> <li><a href="/wiki/Quarantine" title="Quarantine">Quarantine</a></li> <li><a href="/wiki/Source_control_(respiratory_disease)" title="Source control (respiratory disease)">Respiratory source control</a> <ul><li><a href="/wiki/N95_respirator" title="N95 respirator">N95 respirator</a></li> <li><a href="/wiki/Surgical_mask" title="Surgical mask">Surgical mask</a></li> <li><a href="/wiki/Personal_protective_equipment" title="Personal protective equipment">PPE</a></li></ul></li> <li><a href="/wiki/Safe_sex" title="Safe sex">Safe sex</a></li> <li><a href="/wiki/Sanitation" title="Sanitation">Sanitation</a></li> <li><a href="/wiki/Screening_(medicine)" title="Screening (medicine)">Screening</a></li> <li><a href="/wiki/Social_distancing" title="Social distancing">Social distancing</a></li> <li><a href="/wiki/Sterilization_(microbiology)" title="Sterilization (microbiology)">Sterilization</a></li> <li><a href="/wiki/Transmission-based_precautions" title="Transmission-based precautions">Transmission-based precautions</a></li> <li><a href="/wiki/Travel_ban" title="Travel ban">Travel restrictions</a></li> <li><a href="/wiki/Universal_precautions" title="Universal precautions">Universal precautions</a></li> <li><a href="/wiki/Vector_control" title="Vector control">Vector control</a></li> <li><a href="/wiki/Wastewater_surveillance" title="Wastewater surveillance">Wastewater surveillance</a></li> <li>Zoning</li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Emerging_infectious_disease" title="Emerging infectious disease">Emerging <br />infections</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Antigenic_drift" title="Antigenic drift">Antigenic drift</a></li> <li><a href="/wiki/Antigenic_shift" title="Antigenic shift">Antigenic shift</a></li> <li>Antimicrobial resistance surveillance <ul><li><a href="/wiki/EARS-Net" title="EARS-Net">EARS-Net</a></li></ul></li> <li><a href="/wiki/Biosecurity" title="Biosecurity">Biosecurity</a></li> <li><a href="/wiki/CRISPR" title="CRISPR">CRISPR</a></li> <li><a href="/wiki/Disease_X" title="Disease X">Disease X</a></li> <li><a href="/wiki/Emergent_virus" title="Emergent virus">Emergent virus</a></li> <li><a href="/wiki/Evolutionary_epidemiology" title="Evolutionary epidemiology">Evolutionary epidemiology</a></li> <li><a href="/wiki/Genetic_epidemiology" title="Genetic epidemiology">Genetic epidemiology</a></li> <li><a href="/wiki/Global_Health_Initiatives" title="Global Health Initiatives">Global Health Initiatives</a></li> <li><a href="/wiki/Microbial_phylogenetics" title="Microbial phylogenetics">Microbial phylogenetics</a></li> <li><a href="/wiki/One_Health_Model" title="One Health Model">One Health Model</a></li> <li><a href="/wiki/Reassortment" title="Reassortment">Genomic reassortment</a></li> <li>Re-emerging disease</li> <li><a href="/wiki/Reverse_zoonosis" title="Reverse zoonosis">Reverse zoonosis</a></li> <li><a href="/wiki/Evolutionary_pressure#Antibiotic_resistance" title="Evolutionary pressure">Selection pressure</a></li> <li><a href="/wiki/Synthetic_biology" title="Synthetic biology">Synthetic biology</a></li> <li><a href="/wiki/Viral_phylodynamics" title="Viral phylodynamics">Viral phylodynamics</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Discovery_of_disease-causing_pathogens" title="Discovery of disease-causing pathogens">Discovery</a></li> <li><a href="/wiki/Eradication_of_infectious_diseases" title="Eradication of infectious diseases">Eradication</a></li> <li>Economics of Infectious Diseases</li> <li><a href="/wiki/Infectious_disease_(medical_specialty)" class="mw-redirect" title="Infectious disease (medical specialty)">Infectious disease (medical specialty)</a></li> <li><a href="/wiki/Disease_informatics" title="Disease informatics">Infectious disease informatics</a></li> <li><a href="/wiki/Bioterrorism" title="Bioterrorism">Microbial bioterrorism</a></li> <li><a href="/wiki/Pandemic_prevention" title="Pandemic prevention">Pandemic prevention</a></li> <li><a href="/wiki/Tropical_disease" title="Tropical disease">Tropical disease</a> <ul><li><a href="/wiki/Tropical_medicine" title="Tropical medicine">Tropical medicine</a></li></ul></li></ul> </div></td></tr></tbody></table></div> <style data-mw-deduplicate="TemplateStyles:r1130092004">.mw-parser-output .portal-bar{font-size:88%;font-weight:bold;display:flex;justify-content:center;align-items:baseline}.mw-parser-output .portal-bar-bordered{padding:0 2em;background-color:#fdfdfd;border:1px solid #a2a9b1;clear:both;margin:1em auto 0}.mw-parser-output .portal-bar-related{font-size:100%;justify-content:flex-start}.mw-parser-output .portal-bar-unbordered{padding:0 1.7em;margin-left:0}.mw-parser-output .portal-bar-header{margin:0 1em 0 0.5em;flex:0 0 auto;min-height:24px}.mw-parser-output .portal-bar-content{display:flex;flex-flow:row wrap;flex:0 1 auto;padding:0.15em 0;column-gap:1em;align-items:baseline;margin:0;list-style:none}.mw-parser-output .portal-bar-content-related{margin:0;list-style:none}.mw-parser-output .portal-bar-item{display:inline-block;margin:0.15em 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.portal-bar+.navbox-styles+.sister-bar{margin-top:-1px}</style><div class="portal-bar noprint metadata noviewer portal-bar-bordered" role="navigation" aria-label="Portals"><span class="portal-bar-header"><a href="/wiki/Wikipedia:Contents/Portals" title="Wikipedia:Contents/Portals">Portal</a>:</span><ul class="portal-bar-content"><li class="portal-bar-item"><span class="nowrap"><span typeof="mw:File"><span><img alt="icon" src="//upload.wikimedia.org/wikipedia/commons/thumb/d/d6/WHO_Rod.svg/8px-WHO_Rod.svg.png" decoding="async" width="8" height="19" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/d/d6/WHO_Rod.svg/12px-WHO_Rod.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/d/d6/WHO_Rod.svg/16px-WHO_Rod.svg.png 2x" data-file-width="107" data-file-height="250" /></span></span> </span><a href="/wiki/Portal:Medicine" title="Portal:Medicine">Medicine</a></li></ul></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"><style data-mw-deduplicate="TemplateStyles:r1038841319">.mw-parser-output .tooltip-dotted{border-bottom:1px dotted;cursor:help}</style><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1038841319"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1038841319"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1038841319"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1038841319"></div><div role="navigation" class="navbox authority-control" aria-labelledby="Authority_control_databases_frameless&amp;#124;text-top&amp;#124;10px&amp;#124;alt=Edit_this_at_Wikidata&amp;#124;link=https&amp;#58;//www.wikidata.org/wiki/Q12187#identifiers&amp;#124;class=noprint&amp;#124;Edit_this_at_Wikidata" style="padding:3px"><table class="nowraplinks hlist mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><div id="Authority_control_databases_frameless&amp;#124;text-top&amp;#124;10px&amp;#124;alt=Edit_this_at_Wikidata&amp;#124;link=https&amp;#58;//www.wikidata.org/wiki/Q12187#identifiers&amp;#124;class=noprint&amp;#124;Edit_this_at_Wikidata" style="font-size:114%;margin:0 4em"><a href="/wiki/Help:Authority_control" title="Help:Authority control">Authority control databases</a> <span class="mw-valign-text-top noprint" typeof="mw:File/Frameless"><a href="https://www.wikidata.org/wiki/Q12187#identifiers" title="Edit this at Wikidata"><img alt="Edit this at Wikidata" src="//upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/10px-OOjs_UI_icon_edit-ltr-progressive.svg.png" decoding="async" width="10" height="10" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/15px-OOjs_UI_icon_edit-ltr-progressive.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/20px-OOjs_UI_icon_edit-ltr-progressive.svg.png 2x" data-file-width="20" data-file-height="20" /></a></span></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%">National</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><ul><li><span class="uid"><a rel="nofollow" class="external text" href="https://d-nb.info/gnd/4002257-2">Germany</a></span></li><li><span class="uid"><span class="rt-commentedText tooltip tooltip-dotted" title="Antibiotics"><a rel="nofollow" class="external text" href="https://id.loc.gov/authorities/sh85005638">United States</a></span></span></li><li><span class="uid"><span class="rt-commentedText tooltip tooltip-dotted" title="Antibiotiques"><a rel="nofollow" class="external text" href="https://catalogue.bnf.fr/ark:/12148/cb11930914n">France</a></span></span></li><li><span class="uid"><span class="rt-commentedText tooltip tooltip-dotted" title="Antibiotiques"><a rel="nofollow" class="external text" href="https://data.bnf.fr/ark:/12148/cb11930914n">BnF data</a></span></span></li><li><span class="uid"><a rel="nofollow" class="external text" href="https://id.ndl.go.jp/auth/ndlna/00566685">Japan</a></span></li><li><span class="uid"><span class="rt-commentedText tooltip tooltip-dotted" title="antibiotika"><a rel="nofollow" class="external text" href="https://aleph.nkp.cz/F/?func=find-c&amp;local_base=aut&amp;ccl_term=ica=ph118480&amp;CON_LNG=ENG">Czech Republic</a></span></span></li><li><span class="uid"><span class="rt-commentedText tooltip tooltip-dotted" title="Antibióticos"><a rel="nofollow" class="external text" href="http://catalogo.bne.es/uhtbin/authoritybrowse.cgi?action=display&amp;authority_id=XX525122">Spain</a></span></span></li><li><span class="uid"><a rel="nofollow" class="external text" href="https://kopkatalogs.lv/F?func=direct&amp;local_base=lnc10&amp;doc_number=000110502&amp;P_CON_LNG=ENG">Latvia</a></span></li><li><span class="uid"><a rel="nofollow" class="external text" href="http://olduli.nli.org.il/F/?func=find-b&amp;local_base=NLX10&amp;find_code=UID&amp;request=987007295587805171">Israel</a></span></li></ul></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"><ul><li><span class="uid"><a rel="nofollow" class="external text" href="http://esu.com.ua/search_articles.php?id=42870">Encyclopedia of Modern Ukraine</a></span></li></ul></div></td></tr></tbody></table></div> <!-- NewPP limit report Parsed by 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