Bind to the 30S ribosome and prevent the access of aminoacyl tRNA to the acceptor (A) site on the mRNA/ribosome complex and elongation of the peptide chain is arrested

1. Tetracyclines

Bind to the 30S ribosome and prevent the access of aminoacyl tRNA to the acceptor (A) site on the mRNA/ribosome complex and elongation of the peptide chain is arrested. (Tigecycline binds more strongly to the 30S ribosome).

2. Macrolides & Lincosamides

Bind to the 50S ribosome and inhibit the translocation step wherein a newly synthesized peptidyl tRNA molecule moves from the acceptor (A) site to the peptidyltransferase (P) site. They may also cause a conformational change that indirectly terminates protein synthesis.

3. Chloramphenicol

acts at the 50S ribosome and directly interferes with the binding of the amino acid-containing end of aminoacyl tRNA to the peptidyltransferase (P) site

4. Polymyxins

Cationic detergents that interact with anionic lipopolysaccharide molecules in the outer membrane of gram-negative bacteria

5. Vancomycin

Combines with the D-Ala-D-Ala termini of peptidoglycans and arrests cell wall synthesis.

6. Telavancin

Acts in the same manner as vancomycin, but also disrupts bacterial cell membranes, resulting in depolarization and pores in the cell membrane.

7. Daptomycin

Disrupts bacterial cell membrane function by binding to the membrane and causing rapid depolarization, resulting in a loss of membrane potential, leading to membrane disruption and cell death.