sameeralord said:
Hello everyone,
Bacteriocidal- Example quinolones who inhibit DNA synthesis
Bacteriostatic- like aminoglycosides which inhibit protein synthesis
Now my question is bacteriocidal means bacteria must be killed, now if DNA synthesis is inhibited, the bacteria won't be able to replicate and create proteins. Ok the lack of protein would kill the bacteria.
Now bacteriostatic means prevention of bacterial growth. How can inhibiting protein synthesis not kill the bacteria, and how does it prevent bacterial replication.
Also what category does beta lactamases which inhibit cell wall syntheis fall into.
Thanks
Hi Sameera,
The fundamental difference between bactericidal antibiotics and bacteriostatic ones is that, with the former, the bacteria cannot continue to divide even when the drug is removed (they are now considered non-viable or "dead"). In contrast, with the latter, the bacteria don't divide while the drug concentration is high, but recover when the drug is removed, and continue to multiply as before.
In general, it's not so simple to decide if a given antibiotic is going to be bactericidal (that's the right spelling by the way) or bacteriostatic. Often, an in-vitro criterion is used, e.g. >99.9% killing of a defined bacterial inoculum in a defined time frame (often 24 hours) means the drug is bactericidal for those bacteria. Anything less is bacteriostatic. (Studies like these are called killing kinetics studies).
However, this is a fairly arbitrary criterion. Some drugs may be bactericidal to some bacterial genera, but only bacteriostatic to others. Some drugs may be classified as bacteriostatic, but may fulfill the bactericidal criterion at higher doses.
And the distinction may not be that relevant in the clinical context either. Generally, it's only considered "very important" to use bactericidal drugs in preference to bacteriostatic drugs when either a) it's a life-threatening infection, such as bacterial endocarditis or meningitis or b) the patient is very severely immunocompromised e.g. has very low numbers of a particular type of white blood cells (a condition called neutropenia) and likely won't be able to clear the infection without the "extra help". In these cases, bactericidal antibiotics are preferred. But in otherwise healthy people with less severe infections, bacteriostatic antibiotics are fine if there are other conditions favouring them (cost, ease of dosing, less toxicity (side effects)).
Going back to your question as to how a DNA replication inhibitor (the quinolone class) can be bactericidal, well, DNA replication is a critical point in the life-cycle of any organism (prokaryotic like bacteria or eukaryotic like us). A cell generally "commits" itself to cell division (which includes DNA replication as a critical component) and it can't reverse this "decision". If in the midst of replication, it "discovers" there's a spanner in the works (the quinolone inhibiting DNA gyrase and topoisomerase IV, which are indispensable enzymes governing DNA replication), then it "seizes" in the middle of cell division and basically becomes non-viable (dead). Remember that when it comes to bacteria, the permanent incapacitation of their ability to divide is considered death.
Protein synthesis is also an important cellular activity, but shutting it off for a while probably won't impair the organism permanently, especially if the proteins can last for some time and/or there are other metabolic pathways the organism can fall back upon. You must also remember that this is not an "all/none" thing - even with inhibition, some protein synthesis may still be able to continue in the background, albeit at a low level but sufficient to sustain bacterial life. When the block is removed (e.g by the drug being eluted out in-vitro, or metabolised by the human body in-vivo, the bacteria can resume "business as usual").
Beta-lactams like penicillins are almost always considered bactericidal. This is because they act on the cell wall of bacteria, which is the most important barrier against the "outside world". Without a functioning cell wall, the bacteria become vulnerable, and change into forms known as spheroplasts, which are osmotically fragile (they can easily take in water, swell and burst).
Hope this answers most of your questions.