(精选)Antimicrobial Agents教学课件.pptVIP

Mechanisms of Resistance Genetic Mechanisms Non-Genetic Mechanisms Genetic Mechanisms Chromosome-mediated Due to spontaneous mutation: in the target molecule in the drug uptake system Plasmid-mediated Common in Gram-negative rods Transferred via conjugation Multidrug resistance Transposon-mediated Non-Genetic Mechanism Inaccessibility to drugs (e.g., abscess, TB lesion) Stationary phase (insusceptible to inhibitors of cell wall synthesis) Protoplasts and spheroplasts (insusceptible to inhibitors of cell wall synthesis) Antimicrobial Agents Mechanisms of Action and Spectra of Activity OBJECTIVES Describe major classes of antimicrobials and their mechanisms of action Know the spectra of activity of commonly used antibiotics Understand the mechanisms of resistance to antibiotics Know the principle and rationale behind antibiotic susceptibility testing Overview of Antibiotics as Therapeutic Agents Selective Inhibition/Toxicity Due to the differences in structure and metabolic pathways Harm microorganisms, not the host Four major sites: Cell wall Ribosomes DNA Cell membrane Spectrum of Activity Broad Spectrum Antibiotics: Effective against many types Example: Tetracycline Narrow Spectrum Antibiotics: Effective against very few types Example: Penicillin Bactericidal v. Bacteriostatic Bactericidal: Kill bacteria Used when the host defense mechanisms are impaired Required in endocarditis, kidney infection Bacteriostatic: Inhibit bacteria Used when the host defense mechanisms are intact Used in many infectious diseases MECHANISMS OF ACTION OF MAJOR GROUPS OF ANTIBIOTICS STRUCTURE OF ?-LACTAM ANTIBIOTICS “Penicillin Home” Looks like a house with a new room added to the side Think of the R-group as of a funky antenna Changing “antennae” and or finishing the “basement” will create better “homes” (penicillins) [Penicillin] Home Improvement Project Adding a new antenna creates broad spectrum penicillins Example: Ampicil