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Antibiotics

Antibiotics in children

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ANTIBIOTICS
 Antibiotics can be defined as substances capable ofkilling & inhibiting
the growthof micro organisms
 Mechanismof action
Inhibition of cellwall synthesis Penicillins
Cephalosporins
Monobactams
Vancomycin
Inhibition of DNA gyrase: Quinolones
RNA polymerase Rifampicin
Inhibition of protein synthesis: Aminoglycosides
Tetracyclines
Erythromycin
Chloramphenicol
Inhibition of folic acid metabolism: Trimethoprim
Sulfonamides
 Bacteriostatic vs. bactericidal drugs
• Bacteriostatic
– arrest the growth and replication of bacteria
– at serum levels achievable in the patient - limit the spread of infection
while the body's immune system attacks, immobilizes, and eliminates
the pathogens.
– If the drug is removed before the immune system has scavenged the
organisms, enough viable organisms may remain to begin a second
cycle of infection.
• Bactericidal
– kill bacteria at drug serum levels achievable in the patient. - often
drugs of choice in seriously ill patients.
• It is possible for ATB to be bacteriostatic for one organism and bactericidal
for another.
 Antimicrobial activity
• Antimicrobial activity: the ability that a drug kills or suppresses the growth
of microorganisms.
• Minimum inhibitory concentration(MIC)
– the minimum amount of a drug required to inhibit the growth of
bacteria in vitro.
• Minimum bactericidalconcentration(MBC)
– the minimum amount of a drug required to kill bacteria in vitro
 Classificationofantibacterialagents:
bactericidal bacteriostatic
β-lactam agents Erythromycin
Aminoglycosides Tetracyclines
Co-trimoxazole Chloramphenicol
Vancomycin Sulfonamides
 Chemotherapeutic spectra
 Narrow spectrum
only against a single or a limited group of microorganisms,
e.g. INH is active only against mycobacteria.
 Broadspectrum
e.g. tetracycline and chloramphenicol
affect a wide variety of microbial species.
!!! alter the normal bacterial flora
precipitate a superinfection of an organism, e.g., candida.
 Drug resistance
growth of bacteria is not halted by the maximal level of that antibiotic that can be
tolerated by the host.
 Primary
Some organisms are inherently resistant to an antibiotic
e.g., gram-negative organisms are inherently resistant to vancomycin.
 Secondary
spontaneous mutation or acquired resistance and selection.
 Cross-resistance
resistant to more than one antibiotic.

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Antibiotics

  • 1. ANTIBIOTICS  Antibiotics can be defined as substances capable ofkilling & inhibiting the growthof micro organisms  Mechanismof action Inhibition of cellwall synthesis Penicillins Cephalosporins Monobactams Vancomycin Inhibition of DNA gyrase: Quinolones RNA polymerase Rifampicin Inhibition of protein synthesis: Aminoglycosides Tetracyclines Erythromycin Chloramphenicol Inhibition of folic acid metabolism: Trimethoprim Sulfonamides  Bacteriostatic vs. bactericidal drugs • Bacteriostatic – arrest the growth and replication of bacteria
  • 2. – at serum levels achievable in the patient - limit the spread of infection while the body's immune system attacks, immobilizes, and eliminates the pathogens. – If the drug is removed before the immune system has scavenged the organisms, enough viable organisms may remain to begin a second cycle of infection. • Bactericidal – kill bacteria at drug serum levels achievable in the patient. - often drugs of choice in seriously ill patients. • It is possible for ATB to be bacteriostatic for one organism and bactericidal for another.  Antimicrobial activity • Antimicrobial activity: the ability that a drug kills or suppresses the growth of microorganisms. • Minimum inhibitory concentration(MIC) – the minimum amount of a drug required to inhibit the growth of bacteria in vitro. • Minimum bactericidalconcentration(MBC) – the minimum amount of a drug required to kill bacteria in vitro  Classificationofantibacterialagents: bactericidal bacteriostatic β-lactam agents Erythromycin Aminoglycosides Tetracyclines Co-trimoxazole Chloramphenicol Vancomycin Sulfonamides
  • 3.  Chemotherapeutic spectra  Narrow spectrum only against a single or a limited group of microorganisms, e.g. INH is active only against mycobacteria.  Broadspectrum e.g. tetracycline and chloramphenicol affect a wide variety of microbial species. !!! alter the normal bacterial flora precipitate a superinfection of an organism, e.g., candida.  Drug resistance growth of bacteria is not halted by the maximal level of that antibiotic that can be tolerated by the host.  Primary Some organisms are inherently resistant to an antibiotic e.g., gram-negative organisms are inherently resistant to vancomycin.  Secondary spontaneous mutation or acquired resistance and selection.  Cross-resistance resistant to more than one antibiotic.