Principles Of Antimicrobial Therapy

Front 1

Minimum effective concentration needed to inhibit bacterial growth

Back 1

Bacteriostatic

Front 2

Minimum effective concentration needed to kill the bacteria

Back 2

Bacteriocidal

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Bacteriostatic Therapy is needed for:
(5 conditions)

Back 3

1. Bacterial infection in immune compromised host
2. Endocarditis (other intravascular infection)
3. Meningitis and brain abscess
4. Osteomylitis
5. Prosthetic device infection

Front 4

Drug absorption affects antimicrobioal effectiveness how?

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1. Food may help or harm
2. Keoconazole requires acid pH.
Chelation of tetracyclines and fluoroquinolones by cations in antacids may block absorption.

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How are drugs eliminated from the system?

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1. Kidneys
2. Hepatobiliary (Liver)
3. Metobolism (liver)

Front 6

Beta-lactams (penicillins and cephalosporins) action

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Inhibits cell wall synthesis (peptidoglycan) and assembly. Effective against Gram-positive bacteria

Front 7

Examples of Beta-lactams (penicillins and cephalosporins)

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Penicillin G
Cephalothin

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Synthetic beta-lactams examples

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Ampicillin
Amoxicillin
Gram-positive and Gram-Negative bacteria

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Clavulanic Acid mechanism of action

Back 9

Inhibitor of bacterial beta-lactamases
Gram-positive and Gram-negative bacteria

Front 10

Clavulanic Acid examples

Back 10

Augmentin plus Amoxicillin

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Monobactams Action

Back 11

Inhibits steps in cell wall (peptidoglycan) synthesis and murein assembly
Gram-positive and Gram-negative bacteria

Front 12

Monobactams Examples

Back 12

Azteonam

Front 13

Carboxypenems Action

Back 13

Inhibits steps in cell wall (peptidoglycan) synthesis and murein assembly
Gram-positive and Gram-negative bacteria

Front 14

Carboxypenems Examples

Back 14

Imipenem

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Aminoglycosides Action

Back 15

Inhibits translation (protein synthesis)
Gram-positive and Gram-negative bacteria
Gentamicin (Pseudomonas)

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Aminoglycosides Examples

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Streptomycin
Gentamicin

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Glycopeptides Action

Back 17

Inhibits steps in murein (peptidoglycan) biosynthesis and assembly
Gram-positive bacteria espcial S. aureus

Front 18

Glycopeptides Examples

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Vancomycin

Front 19

Lincomycins Action

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Inhibits translation (protein synthesis)
Gram-positive and Gram-negative bacteria especially Bacteroides

Front 20

Lincomycins Examples

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Clindamycin

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Macrolides action

Back 21

Inhibit translation (protein synthesis)

Gram-positive bacteria, Gram-negative bacteria not enterics, Neisseria, Legionella, Mycoplasma

Front 22

Macrolides Examples

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Erythromycin, Azithromycin

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Polypeptides Action

Back 23

Damages cytoplasmic membranes and can
Inhibits steps in murein (peptidoglycan) biosynthesis and assembly
Effective on both Gram-negative bacteria and Gram-positive bacteria

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Polypeptides Examples

Back 24

Polymyxin
Bacitracin
(Bacillus)

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Polyenes Action

Back 25

Inactivate membranes containing sterols

Fungi (Histoplasma and Candida)

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Polyenes Examples

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Amphotericin
Nystatin

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Rifamycins Action

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Inhibits transcription (bacterial RNA polymerase)

Gram-positive and Gram-negative bacteria, Mycobacterium tuberculosis

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Rifamycins Examples

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Rifampicin

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Tetracyclines Action

Back 29

Inhibit translation (protein synthesis)

Gram-positive and Gram-negative bacteria, Rickettsias

Synthetic, add Ehrlichia, Borrelia

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Tetracyclines Examples

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Tetracycline
Doxycycline

Front 31

Chloramphenicol Action

Back 31

Inhibits translation (protein synthesis)
Gram-positive and Gram-negative bacteria

Front 32

Chloramphenicol Examples

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Chloramphenicol

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Quinolones Action

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Inhibit DNA replication
Gram-negative bacteria

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Quinolones Examples

Back 34

Nalidixic acid

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Fluoroquinolones Action

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Inhibits DNA replication
Gram-negative bacteria and some Gram-positive bacteria (b. anthracis)

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Fluoroquinolones Examples

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Ciprofloxacin

Front 37

Growth factor analogs mechanisms of action (3)

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1. Inhibits folic acid metabolism (anti-folate)

2. Inhibits mycolic acid synthesis; analog of pyridoxine (Vit B6)

3. Anti-folate

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Growth factor analogs examples

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Sulfanilamide, Gantrisin, Trimethoprim
Isoniazid (INH)
para-aminosalicylic acid (PAS)

Front 39

Penicillins action

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Penicillin inhibits bacterial growth by interfering with the synthesis of the bacterial cell wall after binding to penicillin binding proteins (many
of these are enzymes are involved in cell wall biosynthesis).

Front 40

Penicillin Resistance

Back 40

Beta-lactamase producers
Alter PB site
Tolerance
Alter cell wall permiability

Front 41

Cephalosporins action

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Inhibits bacterial growth by interfering with the synthesis of the bacterial cell wall after binding to penicillin binding proteins (many
of these are enzymes are involved in cell wall biosynthesis).

Front 42

Cephalosporins Resistance

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1. β-lactamase production
2. Alterations in target penicillin binding proteins.
3. Inability of the drug to reach its binding site: In order to reach its target PBP, a cephalosporin must penetrate an organism’s cell envelope. This is done relatively easily in the case of gram-positive organisms, as the peptidoglycan structure that comprises the cell wall routinely allows the passage of cephalosporin-sized particles. Gram-negative organisms
possess a more formidable barrier, a complex structure composed of polysaccharides, lipids, and proteins. Materials penetrate this outer cell envelope through water-filled channels, or porions, produced by various outer membrane proteins. Passage by a cephalosporin depends on channel size, charge, and hydrophilic properties.

Front 43

Penicillins action

Back 43

Penicillin inhibits bacterial growth by interfering with the synthesis of the bacterial cell wall after binding to penicillin binding proteins (many
of these are enzymes are involved in cell wall biosynthesis).

Front 44

Penicillin Resistance

Back 44

Beta-lactamase producers
Alter PB site
Tolerance
Alter cell wall permiability

Front 45

Cephalosporins action

Back 45

Inhibits bacterial growth by interfering with the synthesis of the bacterial cell wall after binding to penicillin binding proteins (many
of these are enzymes are involved in cell wall biosynthesis).

Front 46

Cephalosporins Resistance

Back 46

1. β-lactamase production
2. Alterations in target penicillin binding proteins.
3. Inability of the drug to reach its binding site: In order to reach its target PBP, a cephalosporin must penetrate an organism’s cell envelope. This is done relatively easily in the case of gram-positive organisms, as the peptidoglycan structure that comprises the cell wall routinely allows the passage of cephalosporin-sized particles. Gram-negative organisms
possess a more formidable barrier, a complex structure composed of polysaccharides, lipids, and proteins. Materials penetrate this outer cell envelope through water-filled channels, or porions, produced by various outer membrane proteins. Passage by a cephalosporin depends on channel size, charge, and hydrophilic properties.