Microbiology Antibiotics 2 Flashcards Preview

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Flashcards in Microbiology Antibiotics 2 Deck (74)
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1

Fluoroquinolones example

• Ciprofloxacin
• Levofloxacin
• Moxifloxacin

2

Aminoglycosides example

• Gentamicin

3

Glycopeptides example

• Vancomycin
• teicoplanin

4

Macrolides example

• Erythromycin
• Clarithromycin

5

Tetracyclines example

• Minocycline

6

Fluoroquinolones: Used

Mainly used in hospital to treat Gram negative infection and lower resp tract infections

7

Fluoroquinolones: Action

By inhibiting DNA gyrase,

8

Fluoroquinolones: Resistance

Increasingly common – mainly target site modification but also efflux pumps.

9

Fluoroquinolones:Absorption

Good oral bioavailability so po often as good as iv

10

Fluoroquinolones:Distribution

Wide tissue distribution (2-3 L/Kg)

11

Fluoroquinolones:Excretion and metabolism

Excretion y metabolism (ciprofloxacin, moxifloxacin)
Renal clearance (Ciprofloxacin, moxifloxacin, levofloxacin)

12

Fluoroquinolones: Side effects

Generally safe:
• Rashes/phototoxicity
• Tendenitis and rupture
• GI upset
• OTC prolongation (moxifloxacin) - (more likely to have ventricular tachy arrhythmia)
• Hepatotoxicity

13

Spectrum-ciprofloxacin: targets

• Aerobic Gram negative bacterial (coliforms, Pseudomonas, gonococci, H. influenza, atypical chest pathogens (legionella,mycoplasma, chlamydia))
• Border line activity against S.aureus and streptococci
• Not active against anaerobes
• Some activity against M. tuberculosis

14

Spectrum – moxifloxacin: Target

• Much improved activity versus Staphylococci and Streptococci
• Poor activity vs. P.aeruginosa, better activity against anaerobes

15

Spectrum – moxifloxacin:Indications

• Community acquired chest infections (moxifloxacin/levofloxacin)
• UTI/acute pyeonephitis (ciprofloxacin, levofloxacin) NB resistanct
• Intraabdominal infection (+ metronidazole)
• Bone/joint infection
• Oral therapy of P.aeruginosa (ciprofloxacin)

16

Aminoglycosides: Action

Inhibiting of protein synthesis at ribosoms

17

Aminoglycosides: Resistance by

Enzymes (aminoglycoside monitoring enzymes) but rare

18

Aminoglycosides: Absorption

Intravenous/Im only
Poor oral absorption

19

Aminoglycosides: Distribution

Modest tissue penetration – concentrated in the kidney and ears (toxicity)

20

Aminoglycosides:Excretion

Renal excretion – accumulation in renal failure, no metabolism

21

Aminoglycosides:Examples

Gentamicin
Tobramycin
Amikacin IV

22

Aminoglycosides: Reduced use because

Toxicity requires therapeutic drug monitoring

23

Aminoglycosides: Antimicrobial spectrum

Broad Gram negative activity
Coliform
P.aeruginosa
No anaerobic activity

24

Aminoglycosides: Indications

1. In combination therapy for intra abdominal infection
2. In combination therapy for infective endocarditis
3. In combination therapy for neutropaenic sepsis
4. In combination therapy for neonatal sepsis (pen/fluclox)
5. In combination therapy for P. aeruginosa infection (Cf)
6. In combination therapy for S. aureus

25

Aminoglycosides: Side effects

7. Nephrotosicity (reversible)
8. Otototoxicity (irreversible)

26

Glycopeptides Example

Vancomycin

27

Glycopeptides Absorption

Intravenous hospital only, wide use to treat multi resistant Gram positive infection, especially MRSA

28

Glycopeptides Action

Inhibiting cross linking of bacterial cell wall

29

Glycopeptides Resistance

Rare except in Enterococci and due to altered target side (enterococci, Staphylococci) and permeability (Staphylococci)

30

Glycopeptides Excretion

Renal

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