Sunday, 5 October 2014

antibiotics

antibiotics 

Short Definition

Anti means against, Bio means life, Tic means Medicines/ Drugs
antibiotics means those drugs which we can use against the life of
micro-organism .

Classification

Classified Antibiotics according to their Machnism of action and their chemical structure.
1 Cell wall synthesis inhabitor .
2 Protein Synthesis inhabitor.
3 DNA RNA Synthesis inhabitor

Antibiotic Classification & Mechanism

Author: 
Topic updated on 09/24/14 3:46pm
Overview of By Mechanism
 
PENICILLINS
CEPHALOSPORINS
FLUOROQUINOLONES
AMINOGLYCOSIDES
MONOBACTAMS
CARBAPENEMS
MACROLIDES
OTHER
Natrual
First generation
Ciprofloxacin (Cipro)
Levofloxacin (Levaguin)
Moxifloxacin (Avelox)
Norfloxacin     
 Amikacin
Gentamicin
Kanamycin
Neomycin
Tobramycin     
 Aztreonam     Ertapenem
Imienem
Meropenem     
Azithromycin
Clarithromycin
Dirithromycin
Erythromycin
Clindamycin     
Vancomycin
Rifampin
Doxycycline
Linezolid
Tetracycline
Trimethoprim/ sulfamethoxacole
Penicillin G
Penicillin-VK
Cephalothin
Cefazolin (Ancef, Kefzol)
Cephapririn
Cephalexin (Keflex)
other
Penicillinase Resistant
Second Generation
Methicillin
Nafcillin
Oxacillin
other
Cefacor
Cefotetan (Cefotan)
other
Aminopenicillins
Third Generation
AmpicillinCeftriaxone (Rocephin)
other
Fourth Generation
Cefpirome
Cefepime
Antibiotic Grouping By Mechanism
Cell Wall SynthesisPenicillins
Cephalosporins
Vancomycin
Beta-lactamase Inhibitors
Carbapenems
Aztreonam
Polymycin
Bacitracin
Protein Synthesis InhibitorsInhibit 30s Subunit
Aminoglycosides (gentamicin)
Tetracyclines
Inhibit 50s Subunit
Macrolides
Chloramphenicol
Clindamycin
Linezolid
Streptogramins
DNA Synthesis InhibitorsFluoroquinolones 
Metronidazole
RNA synthesis InhibitorsRifampin
Mycolic Acid synthesis inhibitorsIsoniazid
Folic Acid synthesis inhibitorsSulfonamides
Trimethoprim
Antibiotic Classification & Indications
Inhibits Cell Wall Synthesis
Penicillins
(bactericidal: blocks cross linking via competitive inhibition of the transpeptidase enzyme)
Class/MechanismDrugsIndications (**Drug of Choice)Toxicity
PenicillinPenicillin G
Aqueous penicillin G
Procaine penicillin G
Benzathine penicillin G
Penicillin V
Strep. pyogenes (Grp.A)**
Step. agalactiae (Grp.B)**
C. perfringens(Bacilli)**
Hypersensitivity reaction
Hemolytic anemia
AminopenicillinsAmpicillin
Amoxicillin
Above +
↑ Gram-negative:
E. faecalis**
E. Coli**
 Above
Penicillinase-resistant-penicillinsMethicillin
Nafcillin
Oxacillin
Cloxacillin
Dicloxacillin
Above +
PCNase-producingStaph. aureus
Above +
Interstitial nephritis
Antipseudomonal penicillinsCarbenicillin
Ticarcillin
Piperacillin
Above +
Pseudomonas aeruginosa**
 Above
Cephalosporins
(bactericidal: inhibits bacterial cell wall synthesis via competitive inhibition of the transpeptidase enzyme)
1st generation Cefazolin
Cephalexin
Staph. aureus**
Staph. epidermidis**
Some Gram-negatives:
E. Coli
Klebsiella
Allergic reaction
Coombs-positive anemia (3%)
2nd generationCefoxitin
Cefaclor
Cefuroxime
Above +
↑ Gram-negative
Allergic Reaction
ETOH Disulfiram reaction
3rd generationCeftriaxone
Cefotaxime
Ceftazidime
Cefepime (4th generation)
Above +
↑ Gram-negative
Pseudomonas
Allergic Reaction
ETOH Disulfiram reaction
Other Cell Wall Inhibitors
Vancomycin q
(bactericidal: disrupts peptioglycan cross-linkage)
 VancomycinMRSA**
PCN/Ceph allegies**
S. aureus
S. epidermidis
Red man syndrome
Nephrotoxicity
Ototoxicity
Beta-lactamase Inhibitors 
(bactericidal: blocking cross linking)
Clavulanic Acid
Sulbactam
Tazobactam
S aureus**S epidermis**E.Coli**
Klebsiella**
Hypersensitivity Reaction
Hemolytic anemia
CarbapenemsImipenem (+ cilastatin)
Meropenem
Doripenem
Ertapenem
Broadest activity of any antibiotic
(except MRSA, Mycoplasma)
AztreonamAztreonamGram-negative rods
Aerobes
Hospital-acquired infections
PolymyxinsPolymyxin B
Polymyxin E
Topical Gram-negative infections
BacitracinBacitracinTopical Gram-positive infections
Protein Synthesis Inhibition
Anti-30S ribosomal subunit
Aminoglycosides
(bactericidal: irreversible binding to 30S) q
Gentamicin
Neomycin
Amikacin
Tobramycin
Streptomycin
Aerobic Gram-negatives
Enterobacteriaceae
Pseudomonas
Nephrotoxicity
Ototoxicity
Tetracyclines
(bacteriostatic: blocks tRNA)
Tetracycline
Doxycycline
Minocycline
Demeclocycline
RickettsiaMycoplasmaSpirochetes (Lyme's disease)Hepatotoxicity
Tooth discoloration Impaired growth
Avoid in children < 12 years of age
Anti-50S ribosomal subunit
Macrolides(bacteriostatic: reversibly binds 50S)Erythromycin
Azithromycin
Clarithromycin
Streptococcus
H. influenzae
Mycoplamsa pneumonia
Coumadin Interaction (cytochrome P450)
Chloramphenicol(bacteriostatic)ChloramphenicolH influenzae
Bacterial Meningitis
Brain absces
Aplastic Anemia
Gray Baby Syndrome
Lincosamide
(bacteriostatic: inhibits peptidyl transferase by interfering with amino acyl-tRNA complex)
ClindamycinBacteroides fragilis
S aureus
Coagulase-negative Staph & StrepExcellent Bone Penetration
Pseudomembranous colitis
Hypersensitivity Reaction
Linezolid
(variable)
LinezolidResistant Gram-positives
StreptograminsQuinupristin
Dalfopristin
VRE
GAS and S. aureus skin infections
DNA Synthesis Inhibitors
Fluoroquinolones
(bactericidal: inhibit DNA gyrase enzyme, inhibiting DNA synthesis)
1st generation  Nalidixic acidSteptococcus
Mycoplasma
Aerobic Gram +
PhototoxicityAchilles tendon rupture
Impaired fracture healing 
q
2nd generationCiprofloxacin
Norfloxacin
Enoxacin
Ofloxacin
Levofloxacin
As Above +Pseudomonasas above
3rd generationGatifloxacinAs above + Gram-positivesas above
4th generationMoxifloxacin
Gemifloxacin
As above + Gram-positives + anaerobesas above
Other DNA Inhibitors
Metronidazole
(bacteridical: metabolic biproducts disrupt DNA)
Metronidazole (Flagyl)AnaerobicsSeizures
Crebelar dysfunction
ETOH disulfram reaction
RNA Synthesis Inhibitors
Rifampin
(bactericidal: inhibits RNA transcription by inhibiting RNA polymerase)
RifampinStaphylococcus
Mycobacterium 
(TB) q
Body fluid discoloration
Hepatoxicity (with INH)
Mycolic Acids Synthesis Inhibitors
IsoniazidIsoniazidzTB
Latent TB
Folic acid Synthesis Inhibitors
Trimethoprim/Sulfonamides(bacteriostatic: inhibition with PABA)Trimethoprim/Sulfamethoxazole (SMX)
Sulfisoxazole
Sulfadiazine
UTI organisms
Proteus
Enterobacter
Thrombocytopenia
Avoid in third trimester of pregnancy
PyrimethaminePyrimethamineMalaria
T. gondii
 Bacteria Overview
Gram Postive Cocci
StaphylococcusStaph. aureus
MSSA
MRSA
Staph. epidermis
Staph saprophyticus
StreptococcusStrep pneumoniae
Strep pyogenes (Group A)
Strep agalacticae (Group B)
Strep viridans
Strep Bovis (Group D)
EnterococciE. faecalis (Group D strep)
Gram Positive Bacilli
Spore FormingBacillus anthracis
Bacillus cereus
Clostridium tetani
Clostridium botulinum
Clostridium perfringens
Clostridium difficile
Non-Spore FormingCorynebacterium diphtheriae
Listeria monocytogenes
Gram Negative Cocci
NeisseriaNeisseria meningitidis
Neisseria gonorrhoeae
Gram Negative Bacilli
EntericsEscherichia coli
Salmonella typhi
Salmonella enteridis
Shigella dysenteriae
Klebsiella pneumoniae
Serratia
Proteus
Campylobacter jejuni
Vibrio cholerae
Vibrio parahaemolyticus/vulnificus
Helicobacter pylori
Pseudomonas aeruginosa
Bacteroides fragilis
Respiratory bacilliHaemophilus influenzae
Haemophilius ducreyi
Bordatella pertussis
Zoonotic bacilliYersinia enterocolitica
Yersinia pestis
Brucella
Francisella tularensis
Pasteurella multocida
Bartonella henselae
OtherGardnerella vaginalis
Other Bacteria
MycobacteriaMycobacterium tuberculosis
Mycobacterium leprae
MOTTS
SpirochetesBorrelia burgdorferi
Leptospira interrogans
Treponema pallidum
ChlamydiaceaeChlamydia trachomatis
Chlamydophila
Rickettsia
Ehrlichia
MycoplasmataceaeMycoplasma pneumoniae
Ureaplasma urealyticum
Fungus-like BacteriaActinomyces israelii
Nocardia