Pharmacology · Antibacterial Spectrum (Aminoglycosides, Macrolides, Tetracyclines, Metronidazole)

Tigecycline, a glycylcycline, overcomes tetracycline efflux pump resistance. At which ribosomal location does tigecycline bind with 5-fold higher affinity than minocycline, explaining its activity against Tet(M)-harboring organisms?

  • A 50S ribosomal subunit near the peptidyl transferase centre, mimicking chloramphenicol binding
  • B Secondary binding site on 50S subunit at the L3/L4 protein interface
  • C Primary binding site on 30S ribosomal subunit (h34 helix of 16S rRNA), blocking A-site tRNA accommodation with steric hindrance from the 9-t-butyl-glycylamido substituent
  • D Initiator tRNA fMet-tRNA binding site on the P-site of 70S ribosome
Correct answer: C. Primary binding site on 30S ribosomal subunit (h34 helix of 16S rRNA), blocking A-site tRNA accommodation with steric hindrance from the 9-t-butyl-glycylamido substituent

Explanation

Tigecycline binds the primary tetracycline binding site on the 30S ribosomal subunit at helix 34 (h34) of 16S rRNA, blocking accommodation of aminoacyl-tRNA in the ribosomal A-site. The bulky 9-tert-butylglycylamido substituent at C-9 of the glycylcycline ring system produces steric clashes that prevent ribosomal protection proteins Tet(M) and Tet(O) — which normally displace tetracyclines from their binding site via GTPase activity — from acting on tigecycline. This explains why tigecycline overcomes both efflux-mediated and ribosomal-protection-based tetracycline resistance. It does not bind the peptidyl transferase centre or 50S subunit.

Reference: KD Tripathi, Essentials of Medical Pharmacology, 8th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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