Some considerations of antibiosis and drug interactions in podiatric surgery

Most antibiotics function via two basic and distinctly different mechanisms. The first mechanism is bacteriocidal in which an antibiotic interferes with bacterial cell wall metabolism causing the destruction of the cell through the resulting cell wall lysis. Bacteriocidal drugs include the penicillins, the cephalosporins, and aminoglycosides. The second mechanism is bacteriostatic wherein a drug interferes with protein synthesis within the cell itself thus inhibiting the growth and multiplication of the cell. This basic action should not be confused with direct cellular destruction. Examples of bacteriostatic drugs are erythromycin, lincomycin, clindamycin, chloramphenicol, and the tetracyclines. A good intellectual exercise would be to imagine using a bacteriostatic drug to inhibit cell reproduction and then to finish off the germ with a good bacteriocidal drug. But ability of a bacteriocidal drug to function depends upon its ability to act on a growing and reproducing bacterial cell, otherwise it won't work. So generally, combination therapy involving both classes of drug is not recommended.