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. 2022 Dec 19;24(1):e56033. doi: 10.15252/embr.202256033

Figure 2. Systemically administered traditional antibiotics in clinical use and clinical trials excluding antitubercular agents.

Figure 2

(A) Cellular targets of traditional antibiotics in clinical use and the clinical pipeline and their resistance mechanisms; (B) Modes of action (MoA) of established and novel traditional antibiotics; (C) Modes of resistance (MoR) of traditional antibiotics; (D) Timeline of the introduction of antibiotics (blue) and examples of resistance identification (red): golden age of antibiotics (blue arrows), introduction of the WHO Pathogen Priority List in 2017 (bold blue; World Health Organization, 2017), natural products (bold), synthetic derived antibiotics (italic), agents not in clinical use anymore (grey); 1. Cell wall synthesis: β‐lactams (penicillins, cephalosporins, carbapenems, monobactams), glycopeptides, phosphonates; 2. Protein synthesis: tetracyclins, aminoglycosides, macrolides, lincosamides, streptogramins, oxazolidinones, amphenicols, pleuromutilins, fusidic acid*; 3. DNA/ RNA synthesis and replication: quinolones, nitroheterocycles (nitroimidazoles, nitrofurans), ansamycins; 4. Folic acid synthesis: sulfonamides, diaminopyrimidines; 5. Cell membrane synthesis and integrity: polymyxins, lipopeptides; 6. Cell division: benzamide; 7. Fatty acid synthesis: afabicin; *approval by European Medicines Agency (EMA).