What Are the Drugs Used to Treat Anaerobic Bacteria?

The human body is susceptible to various bacteria and viruses, such as anaerobes. Once anaerobes appear in the body, necessary measures must be taken for treatment. If anaerobes are left untreated for a long time, many obvious symptoms may appear, and the scope of infection may even expand. To mitigate the harm, patients are advised to promptly use anti-anaerobic drugs. What are the common anti-anaerobic drugs? The commonly used anti-anaerobic drugs include nitroimidazole antibiotics, cephalosporins, and cephalenes.

1. Nitroimidazole antibiotics, such as metronidazole and tinidazole, are broad-spectrum antibacterial agents against anaerobes. They are highly sensitive to Bacteroides fragilis and Clostridium perfringens, but less sensitive to Gram-positive bacilli without spores.

2. Lincomycin, a lincomide antibiotic, has a strong effect against anaerobes and is commonly used for anaerobic infections in the respiratory tract, abdominal cavity, bones, and joints. However, due to increasing drug resistance in recent years, it is only used for mild to moderate anaerobic infections.

3. Cephalosporins and cephalenes, such as cefoxitin, cefmetazole, and cefotetan, have broad-spectrum anti-anaerobic activity and can be used for anaerobic infections and mixed infections, including Bacteroides fragilis. Oxacephems, such as latamoxef, also have good effects against anaerobes.

4. Quinolone antibiotics: Only some newly marketed quinolones, such as moxifloxacin and gatifloxacin, have good activity against anaerobes. In contrast, ofloxacin and ciprofloxacin have little antibacterial activity against anaerobes.

5. β-Lactam antibiotics/β-Lactamase inhibitors: Bacteroides are usually resistant to penicillin and ampicillin due to enzyme production. However, antibiotics with enzymes, such as ampicillin/sulbactam, amoxicillin/clavulanate, and piperacillin/tazobactam, are sensitive to Bacteroides fragilis. Studies have shown that Bacteroides fragilis has low resistance to these antibiotics, less than 2%.

6. Carbapenem antibiotics have a broad antibacterial spectrum and strong activity against aerobic and anaerobic bacteria, making them suitable for severe anaerobic infections.

7. Aminoglycoside antibiotics: Chloramphenicol has broad-spectrum anti-anaerobic activity, easily penetrating cells and crossing the blood-brain barrier. It can be used in combination with penicillin for anaerobic infections in the central nervous system. Long-term and high-dose use can inhibit the hematopoietic system, suppressing the production of red blood cells, white blood cells, and platelets, and occasionally causing aplastic anemia.

8. Glycylcycline antibiotics: Tigecycline, a derivative of minocycline, exhibits broad-spectrum aerobic/anaerobic activity in vitro and has strong effects against anaerobes resistant to metronidazole, clindamycin, and tetracycline. Tigecycline also has a high tissue/plasma ratio, easily penetrating white blood cells and alveolar epithelial cells, making it suitable for the treatment of intracellular and respiratory infections.