Download - Antibiotics -simplified-
Antibiotics
From Prof. Dr. Hussien Khairy Lectures
ByMohamad Alasmar
Oral
Penicillin VLong Acting
Benzathine Penicillin● 2-4 weeks● Ttt of lymphoedema
Broad Spectrum
Amoxicillin +clavulanic Acid =
Augmentin
Ampicillin +Sulbactam =
Unasyn
The Prototype
Crystalline Penicillin● Benzyle Penicillin● Penicillin G
Reversed Spectrum
SelexidIn UTI
AntiPsodomonal
CarbinicllinTicaracillin +clavulanic Acid =
Timentin
PipracillinAnti Beta Lactamase
FlucxacillinFlucluxacillin
Spectrum Side Effects
Very Safe● So used in long term Prophylaxis● Allergy● Enceph;opathy● Electrolytes load
Route
Parentral
Excretion
KidneyBy Tubular Secretion
Mechanism of Action
Cell WallCidal
SpirocheatsG +ve
NOTG –ve
● E Coli● Shigella● Salmonella● Psodomona
s
Anaerobs
First Generation
CephradineVelosef ®Third Generation
Cefoprazone Cefobid®CefotoximeMeningitis
Ceftriaxone Rocephen®Long half lifeOnce A day
Orilox ®oral
Second Generation
MefoxineEffective against anaerobes
Forth Generation
Maxipime®
SpectrumSide Effects
Safe● Allergy may present
Share Pinicillins in allergy in 10% of cases
● HypoprothrombinaemiaRoute
Oral • Parentral1st • 2nd • 3rd • 4th
1. Resist beta lactamase2. Parenteral3. G –ve effective4. Broader spectrum
Excretion
KidneyBy Tubular Secretion
Mechanism of Action
Cell wallCidalLike Pinicillins
G+veG –veSome against anaerobes
Mefoxine
Imipenim + CilastitinEnzyme InhibitorInhibit distruction by Kidney
= Tienam ®● The broadest spectrum ever● Parentral
AztreonamAzactam ®
● Very narrow spectrum● G –ve onle● Parentral
Clavulanic Acid+ Amoxicillin •Augmantin+Ticaracillin •Tementin
Sulbactam+ Cephoperazon •Sulperazon+Ampicillin •Unasyn
Tazobactam
Erythromycin● Like Pinicillin● Used in Pinicillin Allergy● Bowel Preparation
ClarythromycinAntiHelicobacter pylori
AzithromycinZithromax ®Long Half life1 tablet dailyUsed in chest infectionHaemophilus influenza
Spectrum Side Effects
GIT upsets
Route
Oral
Excretion
BiliaryHepatic
Mechanism of Action
Ptn SynthesisStatic •CidalAccording to the dose
NOT G-veG +veAnaerobes
● Bowel Preparation● Like Pinicillin
TobramycinNebcin ®The safest
AmikacinAmikin ®Broadest Spectrum
Garamycin● Very potent● Very toxic● Very cheep
StreptomycinIn TB
Kanamycin● Very toxic● Very old
Neomycin● Bowel Preparation with
Metronidazol
SpectrumSide Effects
NephrotoxicOtotoxicityNeurotoxcity
Route
ParentralNot absorbed by bowel
Excretion
KidneyBy GFNot by excretionSo lower the dose in cases with renal impairment
Mechanism of Action
Ptn SynthesisCidalShould enter the cellNeeds energy = O2So can not act on anaerobes
G +veG –veNOT effective against
anaerobes
CeprofloxacinDrug of Choice in
● Entric Infection● UTI● Prostatitis
OfloxacinTarvid ®
● UTI● Typhoid
LevofloxacinTavanic ®
● Pneumococci● G +ve
Spectrum Side Effects
SafeMusculoskeletal Side Effects
● Young Age • Arthropathy● Old Age • Tendonitis
Not recommended in young ageRoute
Oral & Parentral
Excretion
KidneyBy GF
Mechanism of Action
DNA SynthesisGyrase InhibitorTopoisimerase InhibitorRelax supercoils of DNA to be duplicated
Cidal
G +veG –ve● UTI● Enteric
InfectionBetter than AminoGlycosid Because its less side efects
Side Effects
AntiBiotic Associated colitis =Psudomembranous colitisBy Cl. Difficilttt
● Vencomycin● Metronidazol
Spectrum
Route
ParentralMechanism of Action
Ptn SynthesisExcretion
Kidney
Side Effects
Metallic tasteNeurotoxicNauseaAlcohol • Disulfuram like
Spectrum
●Amebiasis●Trichomonas●Giardia●Anaerobs●Hilicobacter
pylori
Route
OralIV expensiveSuppositories
Excretion
Kidney
Route
OralMRSAMethicillin resistent staph. AureusProduced By Fluxacillin & Flucluxacillin
Pseudomembranous colitisProduced By ClindamycinCl. Difficile
Endocarditis
Mechanism of Action
Cell Wall Synthesis
●Metronidazole●Penicillins●Erythromycin●Tienam●Clindamycin●Mefoxine