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Antibiotics Summary

Med 3

5 major groups of antibiotics (and the antibiotic that doesn't fit) Penicillins, cephalosporins, macrolides, tetracyclines, aminoglycosides, (metronidazole)
Beta-lactams include Penicillins, cephalosporins, carbapenems, mono-bactams
Main causes of infection and gram status Staph/Strep/Enterococci gram +ve, enteric gram -ve, Psuedomonas gram -ve, anaerobes gram +ve or -ve, intracellular/no cell wall
Development of penicillins and cephalosproins Increased spectrum and activity for gram -ve bacteria\
Penicillin characteristics and uses Narrow, gram +ve (mainly Strep.), exceptions e.g. Neisseria susceptible
Amp/Amoxycillin characteristics and uses Resistance problems, gram +ve/-ve
Flucloxacillin characteristics and uses More stable to beta-lactamses, Staph. aureus
Piperacillin charactersitics and uses Extended spectrum, gram -ves, Pseudomonas
Examples of combinations of Penicillins and beta-lactamase inhibitors Co-amoxyclav (augmentin), tazocin
Co-amoxyclav is a combination of Amoxycillin and clavulanic acid
Tazocin is a combination of Piperacillin and tazobactam
Carbepenems examples Imipenem, meropenem
Carbepenems characteristics and uses Extremely broad spectrum (so inhibit normal microflora), uses for mixed and serious infections in hospital patients
Monobactam example Aztreonam
Monobactam uses Limited to gram +ves, useful for carbapenemase producers
Cephalosporins characteristics and uses More beta-lactamase stable, wider range of microbes, poor activity against Enterococcus
Antibacterial activity of beta-lactams depends on Time spent above MIC
Probenicid mechanism and use Competitive inhibition of kidney's organic ion transporter --> decrease excretion of some drugs including cephalosporins
Adverse reactions to beta-lactams allergic, GI (diarrhoea/antibiotic associated colitis especially in co-amoxyclav, yeast overgrowth), rare (biliary sludging in ceftriaxone, nephorotixicity in penicillin, inhibition of blood clotthin in cefamandole, cefotetan)
Aminoglycoside characteristics Low TI, potentially toxic (nephrotoxicity, ototoxicity), adaptive resistance (if bacteria not killed straight away), must be IV, synergy with beta-lactams, post antibiotic effect
Aminoglycoside uses For serious gram -ve infection, Staph. aureus, poor activity against Streps.
Aminoglycoside examples and specific uses gentamicin, tobramycin (Psuedonomonas), amikacin (for gentamicin resistant)
Anibacterial activity of aminoglycosides depends on Height of peak of antibiotic concentration
Which antibiotic is the once-daily regime used for and why Aminoglycosides because they have concentration dependent killing, post antibiotic effect, and the regime is less nephrotoxic (even with renal insufficiency, levels will fall enough before next dose)
Macrolides/azalides examples Erythromycin, roxithromycin, clarithromycin, azithromycin (last 3 have longer plasma half-lifes)
Macrolides/azalides uses gram +ve and intracellular, RTIs, STIs, patients allergic to penicillin, some mycobacteria, use in biofilm infections? (prevent secretion of matrix), no activity against gram -ve enterics or Pseudomonas
Quinolones/fluoroquinolones characteristics Excellent absorption/bioavailability given orally, newer ones very wide spectrum, resistance problems
Quinolones/fluoroquinolones uses Excellent activity against gram -ve aerobic rods
Quinolones/fluoroquinolones examples and specific uses norfloxacin for UTIs, ciprofloxacin for GTIs, moxifloxacin for RTIs (extended spectrum including gram +ves)
Tetracycline characteristics and uses Very broad spectrum, chronic RTIs, chlamydia (both intracellular), not in children/pregnancy
Tetracycline example doxycyline
Treatment for uncomplicated UTIs trimethoprim, nitrofurantoin
Treatment for anaerobes metronidazole
Problems with antibiotics liberation of bacterial cell wall fragments (pro-inflammatory), side effects, allergy, resistance, antibiotic associated diarrhoea, antibiotic associated colitis (especially following clindamycin/chemotherapy for neoplasms)
Created by: skyglow1