Antibiotics, Mode of action, Spectrum of cover , Usage

1. ANTIBIOTICS
Dr. Hafiz Syed Zaigham Ali Shah
PGR NORTH SURGERY

2. CLASSIFICATION OF
ANTIBIOTICS
1- ON BASIS OF
MECHANISMS OF ACTION
2- ON BASIS OF
SPECTRUM AGAINST
BACTERIA

3. 1- MECHANISMS OF ACTION

4. 2- ON BASIS OF SPECTRUM

5.  GRAM
POSITIVE
SPECTRUM
1- PENICILLINS
2- VANCOMYSIN
3- LINEZOLID

6. AMOXICILLIN
 PEDIATRIC DOSAGE: 20-40mg/kg/day 8Hr or 12hr
BRANDS: AMOXIL, SUPRMAX
SPECTRUM: GRAM POSITIVE
COMMON PRACTICE :
ORAL: CAP AMOXIL 250 OR 500MG BD TDS
SYRUP:125mg/5ml. 250mg/5ml

7. AMOXICILLIN-CLAVULINIC
ACID
PEDIATRIC DOSAGE: 20-45mg/kg/day every 8-12hrs.
80-90mg/kg/day for otitis media.
BRANDS: AUGMENTIN , CALAMOX, CO-CLAV
SPECTRUM: GRAM POSITIVE
COMMON PRACTICE:
IV: INJ AUGMENTIN 1.2G x IV x 8Hr
ORAL: TAB AUGMENTIN 1G OR 625MG BD OR TDS
SYRUP: 156mg/5ml , 312mg/5ml.
CALAMOX: 125mg/5ml or 250mg/5ml

8. PENCILLIN-G
PEDIATRIC DOSAGE: 1-4 LAC PER KG/DAY, every
6hrs
BRANDS: BENZYL PENICILLIN
SPECTRUM: GRAM POSITIVE
( STREPTOCOCCAL INFECTIONS)
COMMON PRACTICE:
IV: INJ BENZYL PENICILLIN 6 LAC OR 1.2 MILLION
IU X QID

9. VANCOMYCIN
PEDIATRIC DOSAGE: 40-60mg/kg/day, every 8hrly.
BRANDS: VANCO
Inj:500mg/vial, Inj : 1g/vial
SPECTRUM: Staph and Resistant gram positive
infections. MRSA
COMMON PRACTICE:
IV: INJ VANCO 1g IV 12Hr or INJ VANCO 500MG IV
8Hr

10. LINEZOLID
PEDIATRIC DOSAGE: 10mg per Kg every 8hr or 12
hrly
BRANDS: NEZKIL, EKASIL, LINZD
SPECTRUM: VRSA , VREC
COMMON PRACTICE:
IV: 2mg/ml ( 100ml, 300ml Infusion Bag)
ORAL: TAB NEZKIL 600MG BD FOR 10-14DAYS

11.  GRAM
NEGATIVE
SPECTRUM

12. CEFTRIAXONE
CLASS: CEPHALOSPORIN ( 3rd Generation)
PEDIATRIC DOSAGE: 50-75mg/Kg/day every 12hrly
100mg/kg in case of Meningitis
BRANDS: INJ ROCEPHIN, OXIDIL, CTROX, RHIZONE ,
TITAN , TRIAX
SPECTRUM: GRAM NEGATIVE +++ , GRAM POSITIVE +
COMMON PRACTICE:
IV: Inj Ceftriaxone 1g IV x 12hrly

13. CEFIXIME
CLASS: CEPHALOSPORIN ( 3rd Generation)
PEDIATRIC DOSAGE: 10mg/kg/day every 12hrly or
24hrly
BRANDS: CARICEF, CEFSPAN, CEFIGET
SPECTRUM: GRAM NEGATIVE
COMMON PRACTICE:
ORAL: CAP CARICEF 400mg x OD
SYRUP: 100mg/5ml, 200mg/5ml
ORAL ALTERNATE OF CEFTRIAXONE ON
DISCHARGE

14. IMIPENAM / CILASTIN
CLASS: CARBAPENAM
PEDIATRIC DOSAGE: 10-25mg/kg/6hrly
40-100mg/kg/day
BRANDS: TIENAM
SPECTRUM: BROAD SPECTRUM
COMMON PRACTICE:
IV: INJ TIENAM 500mg x IV x 8hr

15. LEVOFLOXACIN
CLASS: FLOUROQUINOLONES ( 3rd Generation)
PEDIATRIC DOSAGE: 10MG/kg/day once Daily
NOT RECOMMENDED IN YOUNGER AGE
BRANDS: LEFLOX, LEVO, EFIFLOX
SPECTRUM: BRAOD SPECTRUM
COMMON PRACTICE:
IV: Inj LEFLOX 500mg/100ml IV 24hr
ORAL: Tab Leflox 500mg x PO x OD

16. MOXIFLOXACIN
CLASS: FLOUROQUINOLONES ( 3rd Generation)
DOSAGE: LESS THAN 18yrs Contraindicated
BRANDS: MOXIGET, MOFEST , AVELOX
SPECTRUM: BROAD SPECTRUM
COMMON PRACTICE:
IV: Inj MOFEST 400mg/250ml IV x 24hr
ORAL: Tab MOFEST 400mg x PO x OD

17. CIPROFLOXACIN
CLASS: FLOUROQUINOLONES ( 2nd Generation)
PEDIATRIC DOSAGE:
ORAL:20-30mg/kg/day every 8-12hrs.
I/V:4-15mg/kg/day every 8-12hourz
BRANDS: NOVIDAT, CIPROXIN, MYTEL
SPECTRUM: GRAM NEGATIVE +++
COMMON PRACTICE:
IV: INJ 200mg/100ML or 400mg/100ml IV X12Hr
ORAL: 250mg and 500mg PO X BD
SYRUP: 125mg/5ml 250mg/5mL

18. CLARITHROMYCIN
CLASS: MACROLIDES
PEDIATRIC DOSAGE: 7.5-15mg/kg/day,12hrly
BRANDS: Klaricid, Klaritec , Rithmo
SPECTRUM: GRAM NEGATIVE
COMMON PRACTICE:
IV: INJ KALARICID 500mg in NS IV in 2-3hr X 12hr
ORAL: Tab.500mg x PO x BD
SYRUP: 125mg/5ml , 250mg/5ml

19. AZITHROMYCIN
CLASS: MACROLIDES
PEDIATRIC DOSAGE: 10mg/kg/day, 3days
BRANDS: AZOMAX, AZITMA, AZOTAK
SPECTRUM: GRAM NEGATIVE
COMMON PRACTICE:
ORAL: CAP AZOMAX 250mg or 500mg PO X OD for
3-5 days
SYRUP: AZITMA , AZOMAX (200mg/5ml)

20. METRONIDAZOLE
PEDIATRIC DOSAGE: 35-50mg/kg/day every 8hrly
BRANDS: FLAGYL , NETROZOL , MEDAZOLE
SPECTRUM: ANAEROBIC COVER
COMMON PRACTICE:
IV: Inj Flagyl 500mg/100ml IV X 8hr
ORAL: Tab Flagyl 200mg or 400mg PO X TDS
SYRUP: 200mg/5ml

21. TAZOBACTEM +
PIPERACILLIN
PEDIATRIC DOSAGE: 150-300MG/KG/DAY every 8hrly
BRANDS: TANZO
SPECTRUM: BROAD SPECTRUM
COMMON PRACTICE:
IV: INJ TANZO 4.5G IN 100ML NS in MB OVER 30min
IV X 8hrly
INJ TANZO 2.25G IN 100ML NS in MB OVER 30min IV
X 8hrly ( if RFTs are deranged)

22. MEROPENEM
PEDIATRIC DOSAGE: 60-120Mg/kg/day Every 8hrly
BRANDS: MERONEM
SPECTRUM: BROAD SPECTRUM
COMMON PRACTICE:
IV: INJ MERONEM 500mg or 1G IN 100ML NS in MB
OVER 30min IV X 8hrly
MANAGE THE DOSE OF PATIENT
( if RFTs are deranged)

23. TRIMETHOPRIM +
SULFAMETHOXAZOLE (TMP/SFZ)
PEDIATRIC DOSAGE: 10-20Mg/kg/day Every 12hrly
BRANDS: SEPTRAN
SPECTRUM: BROAD SPECTRUM
COMMON PRACTICE:
ORAL : TAB SEPTRAN (TMP/SFZ= 400mg/80mg)
PO X BD
SYP: SEPTRAN (TMP/SFZ= 200mg/40mg per 5ml)

24. SPECIAL
CASES

25. FOR NEONATES
INJ CEFOTAXIME ( 2nd Gen Cephalosporin)
(CLAFRON)
100mg-200mg/kg/day, every 12hrs
VIAL = 250mg/ 500mg /1g
INJ AMIKACIN (Aminoglycoside) (GRACIL)
7.5-10mg/kg every 8hrly
VIAL = 25mg/ml

26. ANTI- TUBERCULOSIS THERAPY

27. ANTI- TUBERCULOSIS THERAPY

28. FOR MALARIA
LUMEFENTRINE +
ARTEMTHER
3mg/kg/day For 3 DAYS
ARCEVA
ORAL: TAB ARCEVA 120/20mg , 240/40mg,
480/80mg PO X OD FOR 3 DAYS
SYP: ARCEVA 90/15mg PO OD FOR 3 DAYS

29. FOR SKIN/ SUBCUTANEOUS
INFECTIONS / MINOR CUTS OR
PATIENTS DISCHARGED AFTER
MOT STITCHING
1- Tab AUGEMENTIN 625mg or 1g PO TDS or BD
respectively for 5-7 days
2- Tab DICLORAN 5omg PO BD or TDS
OR
Tab Brufen 200 or 400 or 600mg PO BD or TDS
OR
Tab Synflex 550mg PO BD or TDS
(GIVE PAIN KILLER ACCORDING TO SEVERITY)
3- Cap Novoteph 20mg or 40mg 30min before breakfast
OD

30. FOR URINARY TRACT
INFECTION
1-Tab Novidat 500mg PO BD for 7
days
2- Tab Dicloran 50mg PO BD / TDS
3- Syp Citralca 1-2TSF PO TDS
OR
Citrosoda Sachte PO BD

31. URETERIC COLLIC
1-Tab Novidat 500mg PO BD for 7 days
2- Tab Dicloran 50mg PO BD / TDS
3- Syp Citralca 1-2 TSF PO TDS
OR
Citrosoda Sachte PO BD
4- Tab Maxflow 0.4mg PO HS ( TAMSULOSIN)
5- Tab Nospa 40mg PO TDS

32. ANAL FISSURE OR PERIANAL
DISEASE
1- TAB NOVIDAT 500MG PO X BD
2- TAB FLAGYL 200 OR 400MG PO x TDS
3- Tab DICLORAN 5omg PO BD or TDS /
Tab Brufen 200 or 400 or 600mg PO BD or TDS/
Tab Synflex 550mg PO BD or TDS
(GIVE PAIN KILLER ACCORDING TO SEVERITY)
4- GTN 0.2% CREAM MIXED WITH LIGNOCAINE GEL X
BD FOR 14 DAYS
IN CASE OF ANAL FISSURE
5- SIDZ BATH
6- STOOL SOFTNERS
SYP DUPHALAC 2 TSF PO x TDS

33. EPIDIDIMO-ORCHITIS OR PELVIC
INFLAMATORY DISEASE (PID)
1- TAB NOVIDAT 500MG PO X BD
2- TAB DOXYCYCLINE (VIBRAMYCIN) 100 MG PO
x TDS
3- Tab DICLORAN 5omg PO BD or TDS
OR
Tab Brufen 200 or 400 or 600mg PO BD or TDS
OR
Tab Synflex 550mg PO BD or TDS
(GIVE PAIN KILLER ACCORDING TO SEVERITY)

34. APD OR SIMPLE GASTRITIS
1- Cap NOVOTEPH / RISEK 20mg Or 40mg before
breakfast OD
2- SYP ULSANIC 2 TSF x PO x TDS
OR
SYP DIGEX MP 2 TSF x PO x TDS
3- Tab ITP 50mg PO TDS before meal
OR
Tab Motillium 10mg PO TDS before meal

35. THANK
YOU