APPENDICES
Appendix A: Antibiotics and Anti-infective Agents by Category and Mechanism of Action
CATEGORIES
|
SUBCATEGORIES
|
MODE of ACTION
|
COMMENTS
|
Antibacterial
|
Sulfonamides
|
Bacteriostatic
|
Broad-spectrum activity against both gram-negative and gram-positive bacteria
|
Penicillins
|
Bactericidal
|
Active against many gram-negative and some gram-positive bacteria
|
Cephalosporins
|
Bactericidal
|
Grouped in four broad classes:
A. First generation: More gram-positive than gram-negative activity
B. Second generation: Enhanced gram-negative activity vs first-generation
C. Third generation: more gram-negative than gram-positive activity
D. Fourth generation: gram-positive and gram-negative activity
|
Tetracyclines
|
Bacteriostatic
|
Broad-spectrum drugs effective against intracellular bacteria
|
Aminoglycosides
|
Bacteriostatic
|
Active against aerobic gram-negative and select aerobic gram-positive bacteria
|
Quinolones
|
Bactericidal
|
Active against both gram-positive and gram-negative bacteria
|
Macrolides
|
Bacteriostatic
|
Also called “erythromycins”; mostly active against gram-positive bacteria
|
Antiviral
|
Interferes with life cycles
|
Prereceptor
|
Neutralizes virus before reaching receptor
|
Receptor
|
Inhibits viral attachment to target cell receptors. Primarily used for HIV infections
|
Transcription/reverse transcription
|
Divided in 2 groups: nucleoside and non-nucleoside analogs
|
Integrase
|
Inhibits integrase, a vital enzyme that integrates viral genome into host genome. Mainly used against retroviruses
|
Protease
|
Inhibits protease. Used in HIV infection
|
Assembly
|
Principally used as anti-influenza drug
|
Release
|
Principally used as anti-influenza drug
|
Antifungal
|
Amphotericin B
|
Damages fungal cell membrane
|
Changes the fluidity of fungal cell membrane
|
Azoles
|
Impair fungal cell membrane
|
Inhibit enzyme cytochrome P450 14α-demethylase
|
Echinocandins
|
Inhibit cell wall synthesis
|
Their target has no mammalian counterpart
|
Flucytosine
|
Nucleic acid analog
|
Administered in combination with amphotericin B
|
|
Appendix A (cont)
CATEGORIES
|
SUBCATEGORIES
|
MODE of ACTION
|
COMMENTS
|
Antiparasite
|
Aminoquinoline (Chloroquine)
|
Suppression or chemoprophylaxis of malaria
|
Treatment of uncomplicated or mild-to-moderate malaria
|
Aminoquinoline (Primaquine)
|
Generates reactive oxygen species or interferes with the electron transport chain in the parasite.
|
Treatment and prevention of malaria
|
Aminoquinoline (Melfoquine)
|
Form toxic complexes with free heme that damage membranes and interact with other plasmodia components
|
Treatment of acute malarial infections and prevention of malaria
|
Abamectin
|
Stunning or killing worms
|
Nematocide
|
Benzimidazole (Albendazole)
|
Stunning or killing worms
|
Effective against threadworms, roundworms, whipworms, tapeworms, hookworms
|
Meglumine antimoniate
|
Disrupts energy production/metabolism of microorganism
|
|
|
Appendix B
Top 8 Most Prescribed Antibiotics (2008)
Antibiotic Name (generic)
|
Select Target
Pathogen(s)
|
Indications
|
Manufacturer
|
2008 Global Sales
(USD Billion)
(estimated)
|
2008
USD Billion
|
Azithromycin
(erythromycin derivative)
|
Haemophilus influenzae, Moraxella catarrhalis, Streptococcus pneumoniae, Chlamydia pneumoniae, Mycoplasma pneumoniae
|
Upper and lower respiratory, urinary tract, middle ear, and soft tissue infections
|
Pfizer
Piva
|
1,280
|
0,7
|
Linezolid
|
S pneumoniae, Streptococcus pyogenes, or Streptococcus agalactiae, Staphyloccocus aureus, vancomycin-resistant enterococci, methicillin-resistant S aureus
|
Pneumonia (hospital acquired), soft tissue infections resistant to antibiotics
|
Pfizer
|
1,100
|
NA
|
Amoxicillin-clavulinate
|
H influenzae, M (Branhamella) catarrhalis,
|
Bacterial infections of the middle ear and upper respiratory tract
|
GlaxoSmithKline
Pfizer (veterinary)
NeoMedD
Mascot
|
1,100
|
0.8
|
Amoxicillin
|
H influenzae, Neisseria gonorrhoeae, Escherichia coli, pneumococci, streptococci, and certain strains of staphylococci
|
Upper and lower respiratory tract infections, middle ear infections in children, urinary tract and skin (cystic acne) infections, and gonorrhea
|
Multiple international manufacturers for nonproprietary preparations
|
1,100 (estimated)
|
0.5
|
Oseltamivir phosphate
|
Seasonal and pandemic influenza A virus
|
Uncomplicated influenza infections and prophylaxis in children <1 year
|
Hoffman-La Roche/Gilead
Chugai Pharma. Co
|
>1.8
|
0.3
|
Cephalexin
|
S pneumoniae, H influenzae, S aureus, S pyogenes, M catarrhalis
|
Urinary tract, skin, and soft tissue infections
|
Eli Lilly
Ranbaxy
|
1.6
|
0.3
|
Trimethoprim
|
E coli, Proteus mirabilis, Klebsiella pneumoniae, Enterobacter species, coagulase-negative Staphylococcus species
|
Urinary tract, upper and lower respiratory tract infections
|
Multiple international pharmaceutical companies
|
0.5 (estimated)
|
0.2
|
|
Appendix C
Pathogens Suspected in the Genesis of Chronic Disorders2-5
1. Chronic Disorders and Cancers
Hepatitis viruses (B and C)
|
Hepatocellular carcinoma
|
Epstein-Barr Virus
|
Lymphomas, nasopharyngeal carcinoma
|
Human papilloma virus 16, 18, 33, 39
|
Cervical, anal, vulvar carcinoma; laryngeal papillomatosis
|
Human herpetic virus-8
|
Kaposi's sarcoma, Castleman's disease
|
Human T-cell leukemia/lymphoma virus-I
|
Adult T-cell leukemia
|
Helicobacter pylori
Mycobacterium paratuberculosis
Tropherima whippelii
Enterovirus
|
Gastric carcinoma, lymphoma
Crohn’s disease
Whipple’s disease
Type 1 diabetes
|
2. Neurologic Disorders
Treponema pallidum
|
Tertiary syphilis (neurosyphilis)
|
Borellia burgdorferi
|
Lyme disease complications
|
Prions
|
Creutzfeldt-Jakob disease variants
|
HHV-6
|
Multiple sclerosis
|
HTLV-I
|
Myelopathy, tropical spastic paraparesis
|
Chlamydophila pneumoniae
|
Alzheimer's disease, multiple sclerosis
|
Bornavirus
|
Autism
|
JC virus
|
Progressive multifocal leukoencephalopathy
|
Herpes simplex virus, cytomegalovirus
|
Mental impairment
|
Rubella
|
Mental impairment
|
Toxoplasmosis
|
Mental impairment, retinal lesions
|
Campylobacter jejuni
|
Guillain-Barré syndrome
|
|
|
|