Q: Why Aminoglycosides are bactericidal while all other protein synthesis inhibitors are bacteriostatic?

Ans:Initial site of action is the outer bacterial membrane.the cationic antibiotic creates fissures in the outer cell membrane,accounts for most of the bactericidal activity. The protein synthesis inhibition of aminoglycosides does not usually produce a bactericidal effect, let alone a rapid one as is frequently observed on susceptible Gram-negative bacilli. Aminoglycosides competitively displace cell biofilm-associated Mg2+ and Ca2+ that link the polysaccharides of adjacent lipopolysaccharide molecules. "The result is shedding of cell membrane blebs, with formation of transient holes in the cell wall and disruption of the normal permeability of the cell wall. This action alone may be sufficient to kill most susceptible Gram-negative bacteria before the aminoglycoside has a chance to reach the 30S ribosome."