3.
Historical Background
Louis Pasteur and Robert Koch 1877
In 1928, Alexander Fleming - Selman Waksman
in 1942 - 1960’s MILES AND BURKE
4. Group/mechanism of Action
1- Cell wall synthesis inhibitors (inh. Peptidoglycan synthesis) B-lactem- Penicillin
/cephalosporins others- vancomycin/ bacitracin
2- Protein synthesis inhibitors (interfere with 50s or 30s of rRNA) Tetracyclines ,
Aminoglycoside , Macrolytes,chloramphenicol clindamycin
3- Folate Antagonists (Sulphonamides) Inhibitor folate synthesis or reduction e.g
sulfamethoxazole, Trimethoprim
4- Quinolones DNA gyrase inhibitors e.g ciprofloxacin, levofloxacin
5- Nitroimidazole E.g metronidazole
5. 8. Base on Spectrum of activity
Narrow spectrum
Extended spectrum
Broad spectrum
6.
7. It is the use of antibiotic to prevent anticipated infection.
Indications for prophylaxis in surgery
Wounds - Clean contaminated and contaminated wound
- Clean wound in which implants or prosthesis are inserted
Animal or Human bite
Open fracture
Delay to cleaning > 6hrs
Foot/ Hand wounds
Wound length > 5cm
Wound involving body cavity/ perineum
Immuno-suppressed patient
Burns
8. Perioperative
It should start with premedication
Should be administer 30min- 1hr before the surgery
Should be intravenous
Aiming at a saturated tissue concentration above MIC at the time of surgery or
manipulation.
Re-administer at 1-2 t½ of the antibiotics for prolonged surgery 24-48 hr is as effective
as administration for 7days
9. 1. Therapeutic antibiotics is given to fight infection that is already . Establish a
Clinical Diagnosis and the need for Antibiotics base on history and physical
examination.
Determine the Urgency of the situation
Non-urgent situation: mild infection or chronic infection
Urgent situation:- Suspected severe infection
Obtain an appropriate clinical specimens for examination
Determine the most likely organism causing the infection
Focus of infection
Age ,Epidemiologic features ,
If multiple antibiotics are available to treat pathogen, choose the best one
Antibiotic combination can be considered to achieve Synergism
