Antibiotics -simplified-


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from Prof. Hussien Khairy lectures
professor of general Surgery KasrAlainy school of medicine - Cairo university
prepared by Mohamed Alasmar - General Surgery resident

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Antibiotics -simplified-

  1. 1. AntibioticsFrom Prof. Dr. Hussien Khairy Lectures By Mohamad Alasmar
  2. 2. Oral The PrototypePenicillin V Crystalline PenicillinLong Acting ● Benzyle Penicillin ● Penicillin GBenzathine Penicillin Reversed Spectrum ● 2-4 weeks ● Ttt of lymphoedema SelexidBroad Spectrum In UTI AntiPsodomonalAmoxicillin +clavulanic Acid =Augmentin CarbinicllinAmpicillin +Sulbactam = Ticaracillin +clavulanic Acid =Unasyn TimentinAnti Beta Lactamase PipracillinFlucxacillinFlucluxacillin
  3. 3. Spectrum Side Effects G +ve Spirocheats Very Safe ● So used in long term Prophylaxis ● Allergy Anaerobs NOT ● Enceph;opathy G –ve ● Electrolytes load ● E Coli Route ● Shigella ● Salmonella Parentral ● Psodomona s ExcretionMechanism of Action KidneyCell Wall By Tubular SecretionCidal
  4. 4. First Generation Second GenerationCephradine MefoxineVelosef ® Effective against anaerobesThird Generation Forth GenerationCefoprazone Maxipime®Cefobid®CefotoximeMeningitisCeftriaxoneRocephen®Long half life
  5. 5. Side EffectsSpectrum Safe G –ve G+ve ● Allergy may present Share Pinicillins in allergy in 10% of Some against anaerobes cases ● Hypoprothrombinaemia Mefoxine Route Oral • Parentral 1st • 2nd • 3rd • 4thMechanism of Action 1. Resist beta lactamaseCell wall 2. Parenteral 3. G –ve effectiveCidal 4. Broader spectrumLike Pinicillins Excretion Kidney By Tubular Secretion
  6. 6. Imipenim + AztreonamCilastitin Azactam ®Enzyme Inhibitor ● Very narrow spectrumInhibit distruction by Kidney ● G –ve onle ● Parentral= Tienam ® ● The broadest spectrum ever ● Parentral
  7. 7. Clavulanic Acid+ Amoxicillin •Augmantin+Ticaracillin •TementinSulbactam+ Cephoperazon •Sulperazon+Ampicillin •UnasynTazobactam
  8. 8. Erythromycin ● Like Pinicillin Azithromycin ● Used in Pinicillin Allergy ● Bowel Preparation Zithromax ® Long Half life 1 tablet daily Used in chest infectionClarythromycin Haemophilus influenzaAntiHelicobacter pylori
  9. 9. Spectrum Side Effects NOT G-ve GIT upsets G +ve Anaerobes Route ● Bowel Preparation Oral ● Like Pinicillin ExcretionMechanism of Action BiliaryPtn Synthesis HepaticStatic •CidalAccording to the dose
  10. 10. Garamycin ● Very potentTobramycin ● Very toxic ● Very cheepNebcin ®The safest Streptomycin In TBAmikacinAmikin ® Kanamycin ● Very toxicBroadest Spectrum ● Very old Neomycin ● Bowel Preparation with Metronidazol
  11. 11. Side EffectsSpectrum Nephrotoxic G +ve G –ve Ototoxicity Neurotoxcity NOT effective against anaerobes Route Parentral Not absorbed by bowelMechanism of ActionPtn Synthesis ExcretionCidal KidneyShould enter the cell By GFNeeds energy = O2 Not by excretionSo can not act on anaerobes So lower the dose in cases with renal impairment
  12. 12. Ceprofloxacin LevofloxacinDrug of Choice in ● Entric Infection Tavanic ® ● UTI ● Pneumococci ● Prostatitis ● G +veOfloxacinTarvid ® ● UTI ● Typhoid
  13. 13. Spectrum Side Effects G +ve Safe G –ve Musculoskeletal Side Effects ● UTI ● Young Age • Arthropathy ● Enteric ● Old Age • Tendonitis Infection Not recommended in young age Better than Route AminoGlycosid Because its less Oral & Parentral side efectsMechanism of Action ExcretionDNA Synthesis KidneyGyrase Inhibitor By GFTopoisimerase InhibitorRelax supercoils of DNA to beduplicated
  14. 14. SpectrumSide EffectsAntiBiotic Associatedcolitis =PsudomembranouscolitisBy Cl. Difficil Routettt ● Vencomycin Parentral ● MetronidazolMechanism of Action ExcretionPtn Synthesis Kidney
  15. 15. Route SpectrumOral ●AmebiasisIV expensiveSuppositories ●TrichomonasExcretion ●GiardiaKidney ●AnaerobsSide Effects ●HilicobacterMetallic tasteNeurotoxic pyloriNauseaAlcohol • Disulfuram like
  16. 16. Route MRSAOral Methicillin resistent staph. Aureus Produced By Fluxacillin &Mechanism of Action FlucluxacillinCell Wall Synthesis Pseudomembranous colitis Produced By Clindamycin Cl. Difficile Endocarditis
  17. 17. ● Metronidazole● Penicillins● Erythromycin● Tienam● Clindamycin● Mefoxine