抗生素英文课件精品 Antimicrobial Chemotherapy方案说明.pptVIP

Antimicrobial Chemotherapypart I Dr. Ross Davidson Rm 309, MacKenzie Building QE II HSC ph: 473-5520 Antimicrobial Chemotherapy Use of drugs to combat infectious agents Antibacterial Antiviral Antifungal Antiparasitic Antimicrobial Chemotherapy Differential toxicity: based on the concept that the drug is more toxic to the infecting organism than to the host Majority of antibiotics are based on naturally occurring compounds or may be semi-synthetic or synthetic What is the ideal antibiotic Have the appropriate spectrum of activity for the clinical setting. Have no toxicity to the host, be well tolerated. Low propensity for development of resistance. Not induce hypersensitivies in the host. Principles / Definitions Treatment vs prophylaxis Prophylaxis - antimicrobial agents are administered to prevent infection Treatment - antimicrobial agents are administered to cure existing or suspected infection Combination Therapy To prevent the emergence of resistance - M.tuberculosis To treat polymicrobial infections Initial empiric therapy Synergy Combination Therapy Why not use 2 antibiotics all the time? Antagonism Cost Increased risk of side effects May actually enhance development of resistance inducible resistance Interactions between drugs of different classes Often unnecessary for maximal efficacy What influences the choice of antibiotic? Activity of agent against proven or suspected organism Site of infection Mode of administration Metabolism and excretion renal and hepatic function Duration of treatment / frequency of dose Toxicity / cost Local rates of resistance How do antimicrobial agents work must bind or interfere with an essential target may inhibit or interfere with essential metabolic process may cause irreparable damage to cell Targets of antibacterial agents Inhibit cell wall production - penicillin binding proteins Inhibit protein synthesis - bind 30s or 50s ribosomal subunits Inhibit nucleic acid synthesis - binding topoisomerases /