Penicillin and carbapenem (beta-lactam) |
Inhibiting bacterial cell wall synthesis |
Escherichia coli and Klebsiella pneumoniae
|
Producing beta-lactamase and carbapenemase and porin alteration |
[26] |
Macrolides |
Inhibiting protein synthesis by binding to the 50S ribosomal subunit |
K. pneumoniae
|
Producing erythromycin esterases (Eres) such as EreA and EreC |
[27,34] |
Ticarcillin (beta-lactam) and ciprofloxacin (quinolone) |
Inhibiting bacterial cell wall and protein synthesis |
Pseudomonas aeruginosa
|
Resistance-nodulation-division (RND) efflux pumps |
[29] |
Macrolides |
Inhibiting protein synthesis |
Streptococcus pneumoniae
|
Ribosomal demethylation, expelling by efflux pump, and target site mutation |
[30] |
Quinolones |
Inhibiting nucleic acid synthesis |
K. pneumoniae and Clostridium perfringens
|
Mutations in the genes that encode gyrase and topoisomerase IV |
[31,32] |
Trimethoprim-sulfamethoxazole |
Inhibiting folate synthesis |
Burkholderia pseudomallei
|
Structural modification of dihydrofolate reductase (DHFR) or dihydropteroic acid synthase (DHPS) |
[33] |