Official reprint from UpToDate®
www.uptodate.com ©2017 UpToDate, Inc. and/or its affiliates. All Rights Reserved.

Penicillin, antistaphylococcal penicillins, and broad-spectrum penicillins

Alyssa R Letourneau, MD
Stephen B Calderwood, MD
Section Editor
David C Hooper, MD
Deputy Editor
Allyson Bloom, MD


Beta-lactam antibiotics are among the most commonly prescribed drugs, grouped together based upon a shared structural feature, the beta-lactam ring. The classification, spectrum of activity and pharmacology of one group of beta-lactam antibiotics, the penicillins, will be reviewed here. The mechanisms of action and resistance and major adverse reactions of the beta-lactam antibiotics are discussed separately. (See "Beta-lactam antibiotics: Mechanisms of action and resistance and adverse effects".) The cephalosporins and other beta-lactam drugs are also discussed separately. (See "Cephalosporins" and "Combination beta-lactamase inhibitors, carbapenems, and monobactams".)


Penicillins can be classified into the following categories:

Penicillin G

Antistaphylococcal penicillins (nafcillin, oxacillin, cloxacillin and dicloxacillin)

Broad-spectrum penicillins: second generation (ampicillin, amoxicillin and related agents), third generation (carbenicillin and ticarcillin) and fourth generation (piperacillin)

To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:

Subscribers log in here

Literature review current through: Nov 2017. | This topic last updated: Jul 26, 2017.
The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate Terms of Use ©2017 UpToDate, Inc.
  1. Tomasz A. Antibiotic resistance in Streptococcus pneumoniae. Clin Infect Dis 1997; 24 Suppl 1:S85.
  2. Friedland IR, McCracken GH Jr. Management of infections caused by antibiotic-resistant Streptococcus pneumoniae. N Engl J Med 1994; 331:377.
  3. Bradley JS, Scheld WM. The challenge of penicillin-resistant Streptococcus pneumoniae meningitis: current antibiotic therapy in the 1990s. Clin Infect Dis 1997; 24 Suppl 2:S213.
  4. Pallares R, Liñares J, Vadillo M, et al. Resistance to penicillin and cephalosporin and mortality from severe pneumococcal pneumonia in Barcelona, Spain. N Engl J Med 1995; 333:474.
  5. Whitney CG, Farley MM, Hadler J, et al. Increasing prevalence of multidrug-resistant Streptococcus pneumoniae in the United States. N Engl J Med 2000; 343:1917.
  6. Herman DJ, Gerding DN. Antimicrobial resistance among enterococci. Antimicrob Agents Chemother 1991; 35:1.
  7. Mulligan ME, Murray-Leisure KA, Ribner BS, et al. Methicillin-resistant Staphylococcus aureus: a consensus review of the microbiology, pathogenesis, and epidemiology with implications for prevention and management. Am J Med 1993; 94:313.
  8. Lowy FD. Staphylococcus aureus infections. N Engl J Med 1998; 339:520.
  9. Jorgensen JH, Doern GV, Maher LA, et al. Antimicrobial resistance among respiratory isolates of Haemophilus influenzae, Moraxella catarrhalis, and Streptococcus pneumoniae in the United States. Antimicrob Agents Chemother 1990; 34:2075.
  10. Heilmann KP, Rice CL, Miller AL, et al. Decreasing prevalence of beta-lactamase production among respiratory tract isolates of Haemophilus influenzae in the United States. Antimicrob Agents Chemother 2005; 49:2561.
  11. Geelen TH, Stassen FR, Hoogkamp-Korstanje JA, et al. Antimicrobial resistance among respiratory Haemophilus influenzae isolates from pulmonology services over a six-year period. Scand J Infect Dis 2013; 45:606.
  12. Bush LM, Johnson CC. Ureidopenicillins and beta-lactam/beta-lactamase inhibitor combinations. Infect Dis Clin North Am 2000; 14:409.