Antibiotics work by disrupting bacterial proteins or enzymes, either preventing their multiplication (bacteriostatic) or killing them outright (bactericidal). Culture and sensitivity tests identify the causative bacteria and most effective antibiotic. Antibiotics include broad-spectrum drugs that affect both gram-positive and gram-negative bacteria, as well as narrow-spectrum drugs for specific types. Overuse of antibiotics can lead to resistance, requiring different classes and combinations of drugs to treat infections. Adverse effects vary by class of antibiotic and must be monitored.

1. Antibiotics nursingstudents.ning.com

2. Antibiotics disrupts proteins or enzymes within a bacterium. bacteriostatic – prevents multiplication bactericidal – kills bacteria Goal : to reduce the number of bacteria  immune system can deal with infection.

3. Culture & Sensitivity test Identify the causative bacteria & the antibiotic which it is most sensitive

4. Gram- positive bacteria cell wall retains stain or resist decolorization by alcohol MC in respiratory & soft tissue infections Gram – negative bacteria cell wall loses stain or decolorized by alcohol MC in GI & GU tract infections Aerobic bacteria vs Anaerobic bacteria

5. Broad – spectrum Antibiotic used for both gram – positive & gram negative bacteria Narrow – spectrum antibiotics used for either gram – positive or gram – negative bacteria Synergistic effect  combination of antibiotics produce greater effects ex. amoxicillin + clavulanic acid ( Augmentin) ampicillin + sulbactam (Unasyn) Prophylaxis  prevention of potential infection.

6. Antibiotic resistance bacteria mutate that they become resistant to certain antibiotics. common in nosocomial infections cause: indiscriminate antibiotic use

7. Cross – resistance resistance that occurs between antibacterials with similar actions.

8. General adverse reactions to antibacterials allergy / hypersensitivity reactions superinfections organ toxicity

9. Classes of Antibiotics

10. Aminoglycosides

11. Drugs gentamicin (Garamycin) M.C. amikacin neomycin tobramycin streptomycin Kanamycin “ M.C.” most common

12. Indications Treatment of serious infections Gm (-) infections {Kleb, enterobacter, E. coli. Proteus, Pseudomonas, Serratia- ( KEEPPS) } Methicillin-resistant staph aureus (MRSA)

13. Action inhibits protein synthesis of gram (–) negative bacteria (bactericidal)

14. Monitor for: nausea & anorexia ototoxicity nephrotoxicity neurotoxicity BM depression & superinfections

15. Cephalosporins

16. Drug cefaclor (Ceclor)

17. Indications Treatment of respiratory dermatological urinary tract middle ear infections

18. Action inhibits cell wall synthesis of wide-range of bacteria (bactericidal )

19. Monitor for: GI upsets & diarrhea Pseudomembranous colitis headache, dizziness nephrotoxicity superinfections & bone marrow suppression hypersensitivity reactions

20. Generations of Cephalosporin

21. 1st generation Drugs cephalexin (Keflex) cefazolin (Zolicef) Indication same as gram – positive bacteria affected by Pen G & gram – negative bacteria ( Proteus mirabilis, E. coli, & Klebsiella pneumoniae) PEcK

22. 2nd generation Drugs cefaclor cefuroxime ( Zinacef) Cefoxitin Indications same as 1 st gen plus Haemophilus influenzae, Enterobacter aerogenes & Neisseria (HENPEcK) Less effective against gram – positive bacteria

23. 3rd generation Drugs ceftazidime ceftriaxone (Rocephin) Ceftizoxime Indication more potent against gram- negative bacilli as well as Serratia marcescens (HENPEcKS)

24. 4th generation Drugs cefepime Ceftditoren Indication for gram – negative & gram – positive organisms including P. aeroginosa

25. Fluoroquinolones

26. Drugs ciprofloxacin (Cipro) M.C. levofloxacin norfloxacin ofloxacin gatifloxacin

27. Indications Treatment of : respiratory infections skin infections urinary tract infections eye infections ear infections bone & joint infections Treatment after anthrax exposure typhoid fever

28. Action inhibit synthesis of bacterial RNA & DNA in wide spectrum of gram – negative bacteria

29. Monitor for: headache, dizziness GI upsets BM depression  Contraindicated in children < 18 yo risk of photosensitivity

30. Macrolides

31. Drugs erythromycin M.C. azithromycin (Zithromax) clarithromycin

32. Indications Treatment of respiratory, skin, urinary tract & GI infections Good alternative if allergic to penicillins

33. Action inhibit protein synthesis (bacteriostatic or bactericidal)

34. Monitor for: nausea & vomiting diarrhea risk for pseudomonas colitis hepatotoxicity ototoxicty

35. Indications similar to macrolides but more toxic. Treatment of serious infections.

36. Monitor for: severe pseudomembranous colitis BM depression pain

37. Monobactam Antibiotic

38. Drug aztreonam

39. Indications Treatment of lower respiratory, skin, urinary tract, intra-abdomina & gynecological infections caused by gram- negative bacteria including septicemia Alternative to pxs allergic to penicillins or cephalosporins.

40. Action inhibit cell wall synthesis of gram- negative enterobacteria

41. Monitor for: mild GI problems liver toxicity pain

42. Penicillins & Penicillinase Resistant Antibiotics

43. Drugs amoxicillin M.C. Natural Penicillins penicillin G penicillin V extended- spectrum penicillin amoxicillin ampicillin penicillinase – resistant antibiotics cloxacillin nafcillin oxacillin

44. Indications Treatment for broad spectrum respiratory & urinary tract infections

45. Action inhibit cell wall synthesis (bactericidal)

46. Monitor for: GI effects superinfections hypersensitivity reactions

47. Sulfonamides

48. Drugs sulfasalazine M.C. sulfadiazine cotrimoxazole

49. Indications Treatment of rheumatoid arthritis, ulcerative colitis

50. Action blocks cellular metabolism of PABA for folic acid synthesis of susceptible gram- positive & gram-negative baceria (bacteriostatic)

51. Monitor for: hepatotoxicity nephrotoxicity Stevens- Johnson syndrome CNS effects & BM depression

52. Tetracyclines

53. Drugs tetracycline M.C. doxyclcine minocycline

54. Indications Treatment of various infections, acne

55. Action inhibit protein synthesis

56. Monitor for: damage teeth & bones GI effects BM suppression, photosensitivity & superinfections make oral contraceptives ineffective

57. Antituberculosis drugs

58. Drugs 1st line drugs isoniazid (INH) rifampin ethionamide rifapentine 2nd line drugs ethambutol pyrazinamide 3rd line drugs capreomycin cycloserine

59. Indication Treatment & prophylaxis of tuberculosis

60. Monitor for: discoloration of body fluids hepatotoxicity peripheral neuritis

61. Leprostatic drugs dapsone clofazimine thalidomide

62. To Prevent Drug- resistant strains of bacteria!!! use antibiotics cautiously complete full course of therapy avoid saving antibiotics for self-medication

63. END nursingstudents.ning.com