抗生素(英文精品) Miscellaneous Antibiotics方案说明.pptVIP

Miscellaneous Antibiotics Polymyxins Active against gram-negative including pseudomonas. Polymyxin B is only available. Bactericidal inhibits cell wall synthesis. Used only topically . Highly nephrotoxic. Spectinomycin Bactericidal ,inhibits protein synthesis by binding to 30S ribosomal subunits. Active against gram positive gram negative organisms. Rapidly absorbed after intramuscular injection. Excreted through kidney . Clinical uses As an alternative treatment for drug- resistant gonorrhea or gonorrhea in penicillin –allergic patients. No cross-resistance with other drugs used in gonorrhea. A single intramuscular dose is given Adverse effects Pain at the site of injection Fever And nausea Nephrotoxicity ( rare ) Clinical uses Severe anaerobic infections ( bones and joints) . Conjunctivitis. In combination with aminoglycoside or cephalosporin to treat penetrating wounds of the abdomen the gut. Infections in female genital tract ( septic abortion ,pelvis abscess ). For prophylaxis of endocarditis in patients with valvular heart disease Plus primaquine is an effective alternative to co-trimoxazole for moderate or severe pneumocystis jiroveci pneumonia in AIDS patients Adverse Effects Diarrhea , nausea, Skin rash Antibiotic-associated colitis Impaired liver function Neutropenia ( not common ) Vancomycin Bactericidal Inhibits bacterial cell wall synthesis Active on gram-positive bacteria including β-lactamase producer those resistant to methicillin. Pharmacokinetics Poorly absorbed from GIT Slow IVI is used for treatment of systemic infections. Widely distributed Cerebrospinal fluid levels are achieved in meningeal inflammation Excreted mainly through renal route Clinical uses Endocarditis or sepsis mainly caused by methicillin –resistant staphylococci. Alternative to penicillin in enterococcal endocarditis( in combination with gentamicin). Meningitis( in combination with cephalosporin) Orally only for the treatment of antibiotic -associated