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Antibiotics simplified
Antibiotics simplified
Antibiotics simplified
Antibiotics simplified
Antibiotics simplified
Antibiotics simplified
Antibiotics simplified
Antibiotics simplified
Antibiotics simplified
Antibiotics simplified
Antibiotics simplified
Antibiotics simplified
Antibiotics simplified
Antibiotics simplified
Antibiotics simplified
Antibiotics simplified
Antibiotics simplified
Antibiotics simplified
Antibiotics simplified
Antibiotics simplified
Antibiotics simplified
Antibiotics simplified
Antibiotics simplified
Antibiotics simplified
Antibiotics simplified
Antibiotics simplified
Antibiotics simplified
Antibiotics simplified
Antibiotics simplified
Antibiotics simplified
Antibiotics simplified
Antibiotics simplified
Antibiotics simplified
Antibiotics simplified
Antibiotics simplified
Antibiotics simplified
Antibiotics simplified
Antibiotics simplified
Antibiotics simplified
Antibiotics simplified
Antibiotics simplified
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Antibiotics simplified

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  • 1. Antibiotics By : Abdullah Taskin -4th year med. Student - BY : Abdullah Taskin 4th y.
  • 2. • Classified according to their MOA into : BY : Abdullah Taskin 4th y.
  • 3. BY : Abdullah Taskin 4th y.
  • 4. BY : Abdullah Taskin 4th y.
  • 5. Penicillin's 1. 2. 3. 4. 5. 6. 7. 8. Benzyl penicillin Aminopenicillin (ampicillin IV - amoxicillin PO) Isoxozoyl penicillin (cloxacillin, methicillin, ) Ureidopenicillin ( piperacillin ) Lactamase Inhibitors (Augmentin – tazobactam ) Cephalosporins ( 1 , 2 , 3 & 4 ) Carbapenems (imipenem ) Vancomycin (Vancocin®) BY : Abdullah Taskin 4th y.
  • 6. Coverage : GP except Staphylococcus, Enterococcus Oral anaerobes (except Bacteroides, Treponema) penicillin MOA : Bactericidal: β-lactam inhibits (PBP) and prevents crosslinking of peptidoglycans BY : Abdullah Taskin 4th y. Indications: actinomycosis, streptococcal pharyngitis, streptococcal skin and soft tissue infections, syphilis Contraindications: Hypersensitivity to penicillin
  • 7. Coverage : sam as B.penicillin MOA : sam as B.penicillin Contraindications: Hypersensitivity to penicillin Aminopenicillin ( Amoxicillin ) Indications: bacterial meningitis , endocarditis , streptococcal , part of H. pylori treatment, UTI BY : Abdullah Taskin 4th y.
  • 8. Coverage : sam as B.penicillin Isoxozoyl penicillin (methicillin ) MOA : sam as B.penicillin Contraindications: Hypersensitivity to Penicillin & > Interstitial nephritis Indications ( only diff. ) : also cover some staph.a BY : Abdullah Taskin 4th y.
  • 9. Coverage : sam as B.penicillin MOA : sam as B.penicillin Ureidopenicillin (Tazocin®) Indications : Same as penicillin & GN: Pseudomonas Anaerobes Contraindications: Hypersensitivity to penicillin Enterococcus BY : Abdullah Taskin 4th y.
  • 10. Coverage : sam as B.penicillin Lactamase Inhibitors (Augmentin®) MOA : sam as B.penicillin Contraindications: Hypersensitivity to Penicillin & jaundice or hepatic dysfunction Indications : Same as penicillin +/& Staphylococcus H. influenzae Enterococcus BY : Abdullah Taskin 4th y.
  • 11. Cephalosporins ( 1 , 2 , 3 & 4 ) widely used BY : Abdullah Taskin 4th y.
  • 12. Coverage : GP except Enterococcus Ceph.S. 1st (cephalexin , cefazolin) & GN except E. coli, Klebsiella, Proteus MOA : same as penicillin (B-lactam) Indications: GP “more” & GN Contraindications: Hypersensitivity to Penicillin or ceha.S. & Nephrotoxicity BY : Abdullah Taskin 4th y.
  • 13. Coverage : GP week & GN & anaerobes MOA : same as penicillin (B-lactam) Ceph.S. 2nd (Ceftin®) , Cefprozil (Cefzil®)) Contraindications: Hypersensitivity to Penicillin or ceha.S. BY : Abdullah Taskin 4th y.
  • 14. Coverage : GP Staph & strep. & GN broad + pseudomonas MOA : same as penicillin (B-lactam) Ceph.S. 3rd (cefixime, ceftriaxone , cefotaxime & ceftazidime ) Indications: RTI, gonorrhea (use cefixime), meningitis, septicemia, abdominal infections Contraindications: Hypersensitivity to Penicillin or ceha.S. BY : Abdullah Taskin 4th y.
  • 15. Coverage : Ceph.S. 4th (cefepime) (good for gram +ve and –ve) & pseudomonas “penetrates the CSF” MOA : same as penicillin (B-lactam) Contraindications: Hypersensitivity to Penicillin or ceha.S. BY : Abdullah Taskin 4th y.
  • 16. Cephalosporins (β-Lactam) : a) Renal elimination b) Ceftriaxone & Cefoperazone biotransformation in the liver. c) Thrombocytopenia associated with cefamandole and cefoperazone NOT cefotetan!! d) Pyrogenic (highest rates of drug induced fever) BY : Abdullah Taskin 4th y.
  • 17. Coverage : GN only & work with aminoglycosides MOA : (B-lactam) Monobactams β-Lactam Aztreonam Indications: patients who are allergic to penicillins or cephalosporins Contraindications: Not allergic . BY : Abdullah Taskin 4th y.
  • 18. Coverage : GP except Enterococcus, MRSA GN including Pseudomonas + Enterobacter Anaerobes MOA : (B-lactam) Carbapenams β-Lactam: (Imipenam ) Indications: LARGEST SPECTRUM OF ACTIVITY of any B-lactam Rx: Septicemia of unknown origin Major disadvantages: metabolize by kidney > cause decreased urinary concentration. SE: seizers ,rash so IMIPENAM + CILASTATIN (inhibitor of enzyme) are given together. BY : Abdullah Taskin 4th y.
  • 19. Coverage : GP except Enterococcus, MRSA GN including Pseudomonas + Enterobacter Anaerobes Carbapenams β-Lactam: (meropenem ) Major disadvantages: not need CILASTATIN & Less seizures MOA : (B-lactam) BY : Abdullah Taskin 4th y.
  • 20. Coverage : NON β-Lactam: ( VANCOMYCIN ) GP (strong) MOA : Indications: GP: (RESISTANT to methicillin) e.g. MRSA & MRSE must be given IV NO GI Glycopeptide stearically inhibits addition of peptidoglycan subunits Major disadvantages: Red Man Syndrome , Nephrotoxicity , Ototoxicity , Neutropenia, Thrombocytopenia BY : Abdullah Taskin 4th y.
  • 21. NON β-Lactam: (FOSFOMYCIN ) Coverage : Gram +ve and – ve spectrum MOA : Indications: SINGLE DOSE Of uncomplicated UTI : treatment of ONLY IN FEMALES!! inhibit cell wall BY : Abdullah Taskin 4th y.
  • 22. Contraindicated in pregnancy 1. Aminoglycosides 2. Erythromycin 3. Clarithromycin 4. Tetracyclines 5. Fluoroquinolones BY : Abdullah Taskin 4th y.
  • 23. Protein synthesis inhibitors : BY : Abdullah Taskin 4th y.
  • 24. 50 S A- Macrolides Protein synthesis inhibitors B- Lincosamides 1) Erythromycin 1) clindamycin 2) clarithromycin 2) Chloramphenico 3) azithromycin 3) linezolid BY : Abdullah Taskin 4th y. 30 S 1- Aminoglycosides 2- Tetracyclines
  • 25. Macrolides Coverage : GP except Enterococcus & GN “Atypicals” MOA : inhibit 50 S Indications: Clarithromycin = H.pyloric Azithromycin = Co-drug of choice for Chlamydia & Safe in pregnancy . Major disadvantages: GI upset , acute cholestatic hepatitis Prolonged QT Hypersensitivity BY : Abdullah Taskin 4th y.
  • 26. clindamycin Coverage : GP except Enterococcus & Anaerobes MOA : inhibit 50 S clindamycin =Pseudomembranous colitis Chloramphenicol= Aplastic anemia & Grey baby syndrome linezolid = HTN , myelosuppression optic neuropathy, peripheral neuropathy BY : Abdullah Taskin 4th y.
  • 27. Aminoglycosides Coverage : GN & psudomonas MOA : inhibit 30 S Indications: G - & no alternatives . Major disadvantages: Nephrotoxicity Ototoxicity BY : Abdullah Taskin 4th y.
  • 28. Coverage : GP Anaerobes Atypicals: Chlamydophila, Mycoplasma, Treponema prophylaxis MOA : inhibit 30 S Tetracyclines Indications: Rickettsial infections, Chlamydophila, acne malaria prophylaxis (doxycycline). Major disadvantages: Hepato-renal toxicity, Fanconi’s syndrome, Photosensitivity, Teratogenic, Yellow teeth and stunted , Taskin 4th y. growth in children,( not in preg.) bone BY : Abdullah
  • 29. Coverage : Poor GP activity GN Atypicals FIncludes anaerobes No Pseudomonas coverage TOPOISOMERASE INHIBITORS : Fluoroquinolones Indications: Only use when necessary to prevent resistance except : ciprofloxacin MOA : Inhibits DNA gyrase Dysglycemia Major disadvantages: Allergy , Seizures , Prolonged QT BY : Abdullah Taskin 4th y.
  • 30. Coverage : GPC N. meningitidis H. influenza Mycobacteria MOA : Inhibits RNA polymerase TOPOISOMERASE INHIBITORS : Rifampin Indications: TB , latent TB , Endocarditis & prophlaxis N. meningitides exposure Major disadvantages: Hepatic dysfunction, P450, Orange tears/saliva/urine & Jaundice BY : Abdullah Taskin 4th y.
  • 31. Coverage : Anaerobes Protozoa MOA : Forms toxic metabolites in bacterial cell which damage microbial DNA TOPOISOMERASE INHIBITORS : Metronidazole (Flagyl®) Indications: Protozoal infections (trichomonas, amebiasis, giardiasis), bacterial vaginosis, anaerobic bacterial infections Major disadvantages: Seizures Peripheral neuropathy , BY : Abdullah Taskin 4th y.
  • 32. Coverage : GP GN: enteric Nocardia Other: Pneumocystis, Toxoplasmosis MOA : Inhibits folic acid production (TMP inhibits DHFR and SMX is a competitive inhibitor of PABA) ANTI-METABOLITE: Trimethoprim- Sulfamethoxazole (TMP/SMX) Major disadvantages: Hepatitis , Stevens Johnson syndrome TMP: - Megaloblastic anemia - Leuko/granulocytopenia - Hyperkalemia SMX: - Hypersensitivity - Interstitial nephritis - BM suppression BY : Abdullah Taskin 4th y.
  • 33. Remain : • Antimyobacterial ( rifampicin covered above ) BY : Abdullah Taskin 4th y.
  • 34. Appendix BY : Abdullah Taskin 4th y.
  • 35. Basic : G.ngative vs. G.positive BY : Abdullah Taskin 4th y.
  • 36. BY : Abdullah Taskin 4th y.
  • 37. Properties of penicillin : • All penicillin has Beta lactam ring . • Trans-peptidase or (penicillin-binding protein) • Function : Synthesis of peptidoglycan layer . • To be effective Penicillin must : I. Penetrate cell layer II. Keeps it beta lactam ring intact III.Bind to Trans-peptidase . BY : Abdullah Taskin 4th y.
  • 38. How bacteria defended from penicillin ? In three ways : 1) G. negatives prevent penetration of cell layers by alteration of porins. 2)G. negatives destroy beta-lactam in periplasmic space . 3) Bacteria inhibit binding of B.lactam to transpeptidase by altering structure of Trans-peptidase . BY : Abdullah Taskin 4th y.
  • 39. References : • Ananthanarayan & Pinker’s 8th edition . • Clinical Microbiology Made Ridiculously Simple – 3rd edition BY : Abdullah Taskin 4th y.
  • 40. Thank you … BY : Abdullah Taskin 4th y.
  • 41. BY : Abdullah Taskin 4th y.

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