Tiamulin

**Tiamulin** is a semisynthetic diterpene pleuromutilin-class antibiotic primarily utilized in swine medicine. It is highly effective against *Mycoplasma* spp., spirochetes (such as *Treponema/Brachyspira hyodysenteriae*, the causative agent of swine dysentery), and various gram-positive cocci (including most *Staphylococcus* and *Streptococcus* species, excluding group D). While its activity against most gram-negative organisms is poor, it does maintain efficacy against *Haemophilus pleuropneumoniae* and select strains of *E. coli* and *Klebsiella*. > **Clinical Pearl:** Tiamulin's unique diterpene structure makes cross-resistance with other antibiotic classes less common. However, because it shares a ribosomal binding site with macrolides and lincosamides, concurrent use should be avoided to prevent competitive antagonism.

กลไกการออกฤทธิ์: Tiamulin acts by binding to the **50S ribosomal subunit** at the peptidyl transferase center → blocks the correct positioning of tRNA → **inhibits bacterial protein synthesis**. It is generally **bacteriostatic**, but can become **bactericidal** at very high concentrations against highly susceptible organisms.

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